Sun W, Wang X Y, Yu L, Lin L, Zhang H L, Zhou Y M, Su C H, Chen D J
Department of Obstetrics and Gynecology, Key Laboratory of Obstetric Major Diseases, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
Zhonghua Fu Chan Ke Za Zhi. 2019 Aug 25;54(8):512-515. doi: 10.3760/cma.j.issn.0529-567x.2019.08.002.
To investigate the ratio of transfer cesarean section after trial of labor and maternal-fetal outcomes based on Robson classifications. The delivery data by cesarean section in Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2009 to December 31st, 2015 (gestational age ≥28 weeks and newborn birth weight 1 000 g) were retrospectively collected. The ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes were analyzed by weighted adverse outcome score in different Robson classifications. (1) The highest ratio of transfer cesarean section after trial of labor was classification 9 (all abnormal lies, including previous cesarean section and breech were excluded) reached 47.31% (431/911) , followed by classification 2 (nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced) accounted for 44.90%(409/911). (2)The tops of weighted adverse outcome score of transfer cesarean section after trial of labor were classification 10 (single cephalic pregnancy at <37 weeks gestation, including women with previous cesarean delivery) 24.55, classification 5 (single cephalic pregnancy multiparous women, with at least one previous cesarean delivery, ≥37weeks gestation) 3.64. Carefully evaluating the delivery mode and emphasizing the intrapartum management in nulliparous women with a single cephalic pregnancy, at ≥37 weeks gestation who had labour induced and trial of labor after cesarean section is essential to reduce the risk of adverse outcomes in transfer cesarean section after trial of labor.
基于罗布森分类法，探讨试产后中转剖宫产的比例及母胎结局。回顾性收集广州医科大学附属第三医院2009年1月1日至2015年12月31日剖宫产分娩资料（孕周≥28周且新生儿出生体重≥1000g）。采用加权不良结局评分法分析不同罗布森分类法下试产后中转剖宫产的比例及母胎不良结局。（1）试产后中转剖宫产比例最高的是分类9（排除所有胎位异常，包括既往剖宫产和臀位），达47.31%（431/911），其次是分类2（孕周≥37周、单头位妊娠、引产的初产妇），占44.90%（409/911）。（2）试产后中转剖宫产加权不良结局评分最高的是分类10（孕周<37周的单头位妊娠，包括有既往剖宫产史的女性），为24.55，分类5（单头位妊娠经产妇，既往至少有一次剖宫产史，孕周≥37周）为3.64。对于孕周≥37周、单头位妊娠、引产的初产妇及剖宫产后试产的产妇，仔细评估分娩方式并加强产时管理，对于降低试产后中转剖宫产不良结局的风险至关重要。
