Pirhonen Jouko, Erkkola Risto
The Norwegian Continence and Pelvic Floor Center, University Hospital of North Norway, Tromsø, Norway.
Department of Obstetrics and Gynecology, Turku University Central Hospital, Turku, Finland.
Eur J Obstet Gynecol Reprod Biol. 2021 May;260:150-153. doi: 10.1016/j.ejogrb.2021.03.027. Epub 2021 Mar 19.
The clinical management of intrauterine fetal demise (IUFD) in women with a previous cesarean delivery presents a dilemma for the obstetrician. With the current reluctance of obstetricians to perform vaginal birth after cesarean (VBAC) and the paucity of data to counsel women regarding maternal risks, management options are limited by physician's clinical experience and biases. In the setting of fetal demise, maternal safety becomes the primary concern. Medicolegal pressures may prevent physicians from attempting a trial of labor in this situation. In this review we will a focus on frequency of birth with IUFD after cesarean section (CS), we discuss the options (VBAC vs CS), different complications, methods for induction of vaginal birth as well as risk factors of vaginal birth and cesarean delivery.
对于有剖宫产史的女性，宫内死胎（IUFD）的临床管理给产科医生带来了两难困境。鉴于目前产科医生不愿进行剖宫产术后阴道分娩（VBAC），且缺乏指导女性了解母体风险的数据，管理选择受到医生临床经验和偏见的限制。在胎儿死亡的情况下，母体安全成为首要关注点。医疗法律压力可能会阻止医生在这种情况下尝试阴道试产。在本综述中，我们将重点关注剖宫产术后发生宫内死胎后的分娩频率，讨论相关选择（VBAC与再次剖宫产）、不同并发症、诱导阴道分娩的方法以及阴道分娩和剖宫产的风险因素。
