Meehan F P
Department of Obstetrics and Gynaecology, University College Galway, Ireland.
Clin Exp Obstet Gynecol. 1988;15(4):117-23.
During the ten year study period, April 1972 to March 1982, there were 1,498 patients, with one or more prior caesarean section delivered at the Regional Hospital, University College, Galway. Trial of scar (TOS) was undertaken in 844 (56.34%) patients and the remaining 654 (43.66%) had a repeat elective caesarean section. There were 546 (64.69%) TOS patients who had some form of induction/augmentation and in 269 (49.26%) oxytocin was used, singularly and in combination with other induction methods and successful vaginal delivery was attained in 222 (82.52%) patients. There was no increased incidence of true rupture (TR) or bloodless dehiscence (BD) associated with the use of induction/augmentation or oxytocin in this series. There was a 50% perinatal mortality associated with TR, but there was no maternal death in TOS patients, with or without a successful trial. An incidence of TR of 1:169 patients is no justification for the "once a section, always a section" idiology, widely practiced in North America today.
在1972年4月至1982年3月的十年研究期间，戈尔韦大学学院地区医院有1498例有过一次或多次剖宫产史的患者。844例（56.34%）患者进行了瘢痕试产（TOS），其余654例（43.66%）进行了择期再次剖宫产。546例（64.69%）TOS患者采用了某种形式的引产/催产，其中269例（49.26%）单独或联合其他引产方法使用了缩宫素，222例（82.52%）患者成功经阴道分娩。在该系列研究中，使用引产/催产或缩宫素并未增加子宫破裂（TR）或无血裂开（BD）的发生率。TR相关的围产儿死亡率为50%，但TOS患者无论试产是否成功均无孕产妇死亡。1:169的子宫破裂发生率并不能成为当今北美广泛实行的“一次剖宫产，永远剖宫产”观念的依据。
