Department of Obstetrics and Gynecology, Health Sciences University, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
Ginekol Pol. 2021;92(4):306-311. doi: 10.5603/GP.a2020.0132. Epub 2021 Jan 15.
To evaluate maternal-neonatal results in women who underwent vaginal birth after cesarean (VBAC) and elec-tive repeat cesarean delivery (ERCD).
In a two-year retrospective cohort analysis, 423 patients with a history of prior cesarean section, singleton pregnancy with cephalic presentation and gestational age of 37-41 weeks were investigated. The maternal and perinatal outcomes of 195 patients desiring VBAC and undergoing a trial of labor after cesarean (TOLAC) attempt and 228 patients undergoing an ERCD were compared.
While the TOLAC attempt was successful in 141 patients (72.3%), it was unsuccessful in 54 patients. No statistically significant difference was determined between VBAC and ERCD patients regarding uterine rupture, dehiscence, post-partum hemorrhage, the need for a blood transfusion and wound site infection (p > 0.05). When the post-partum neonatal outcomes were compared, there was no statistically significant difference between VBAC and ERCD groups regarding the prevalence of admission to the neonatal intensive care unit (NICU), respiratory distress, sepsis and birth injury (p > 0.05).
The maternal and perinatal outcomes of our study may be encouraging in favor of VBAC particularly in countries with higher cesarean rates. We think that the option of VBAC should be offered more frequently for selected appropriate patients in created safe environments.
评估行阴道分娩（VBAC）和选择性重复剖宫产（ERCD）的剖宫产术后产妇-新生儿结局。
在一项为期两年的回顾性队列分析中，对 423 例有剖宫产史、头位单胎妊娠且孕周为 37-41 周的患者进行了研究。比较了 195 例有 VBAC 意愿并接受剖宫产试产（TOLAC）尝试和 228 例接受 ERCD 的患者的母婴围生结局。
141 例（72.3%）TOLAC 尝试成功，54 例尝试失败。VBAC 和 ERCD 患者在子宫破裂、裂开、产后出血、需要输血和伤口部位感染方面无统计学差异（p>0.05）。比较产后新生儿结局时，VBAC 和 ERCD 组在新生儿重症监护病房（NICU）入院率、呼吸窘迫、败血症和产伤方面无统计学差异（p>0.05）。
在剖宫产率较高的国家，我们的研究结果可能对 VBAC 的母婴围生结局有利。我们认为，在安全的环境下，应更频繁地为选择合适的患者提供 VBAC 选项。
