双子宫患者剖宫产术后经阴道分娩1例。
A Case of Vaginal Birth after Cesarean Delivery in a Patient with Uterine Didelphys.
作者信息
Wong Jennifer W H
机构信息
Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
出版信息
Case Rep Obstet Gynecol. 2019 Dec 23;2019:3979581. doi: 10.1155/2019/3979581. eCollection 2019.
BACKGROUND
The American College of Obstetricians and Gynecologists (ACOG) recommends that most women with one prior low-transverse cesarean delivery should be offered a trial of labor after cesarean (TOLAC). However, very little is known about TOLAC in women with uterine anomalies.
CASE
A 32-year-old gravida-2 para-1 female with a history of uterine didelphys and one prior low-transverse cesarean section in the left uterine horn presented with a subsequent pregnancy in the left uterine horn. After extensive counseling on TOLAC versus repeat cesarean delivery, the patient decided to proceed with TOLAC and had a spontaneous vaginal delivery of a healthy infant at 38 3/7 weeks of gestation.
CONCLUSION
TOLAC can be considered in women with uterine anomalies using ACOG's standard TOLAC guidelines with informed consent and shared decision-making between the patient and obstetrician.
背景
美国妇产科医师学会（ACOG）建议，大多数曾有一次低位横切口剖宫产史的女性应接受剖宫产后试产（TOLAC）。然而，对于子宫异常女性的TOLAC情况，人们知之甚少。
病例
一名32岁、孕2产1的女性，有双子宫病史，曾在左侧子宫角行一次低位横切口剖宫产，此次妊娠发生在左侧子宫角。在就TOLAC与再次剖宫产进行广泛咨询后，患者决定进行TOLAC，并在妊娠38 3/7周时自然阴道分娩出一名健康婴儿。
结论
对于子宫异常的女性，可根据ACOG的标准TOLAC指南，在患者与产科医生知情同意并共同决策的情况下考虑进行TOLAC。
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