Rouzi Abdulrahim A, Alamoudi Rana, Ghazali Sarah, Almansouri Nisma, Kafy Abdullah, Alrumaihi Meshari, Hariri Wajeh, Alsafri Esraa
Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Womens Health. 2021 Nov 10;13:1081-1086. doi: 10.2147/IJWH.S334617. eCollection 2021.
PURPOSE: To assess the maternal and neonatal outcomes of repeated trials of labor after one previous cesarean section. MATERIALS AND METHODS: We identified and reviewed the records of all women who had had a trial of labor after cesarean section at a tertiary care center in Saudi Arabia between January 1, 2011, and December 30, 2018. The inclusion criteria were women with singleton vertex pregnancies between 24 and 42 weeks of gestation and a trial of labor after one cesarean section. The exclusion criteria were two or more previous cesarean sections, intrauterine fetal demise, breech presentation, labor induction, estimated fetal weight >4 kg, and classical or low vertical uterine incision. The pregnancy outcomes of these women were compared according to the number of trials of labor after cesarean section. RESULTS: During the study period, 1139 women met the inclusion criteria. The number of women with previous zero, one, two, or three or more trials of labor after cesarean section were 669 (58.7%), 237 (20.8%), 132 (11.6%), and 101 (8.9%), respectively. There were statistically significant trends between the four groups in age, nationality, gravidity, and parity but not in the booking status, BMI, or the hemoglobin level before a trial of labor after cesarean section. The rate of vaginal birth after cesarean section increased significantly (p<0.001) from 72.9% with zero to 93.3% with one, 93.9% with two, and 94.1% with three or more trials of labor after cesarean section. CONCLUSION: Previously successful vaginal births after cesarean delivery are associated with improved maternal and neonatal outcomes in the subsequent trials of labor after cesarean delivery.
目的:评估既往有一次剖宫产史后再次进行引产的母婴结局。 材料与方法:我们识别并回顾了2011年1月1日至2018年12月30日期间在沙特阿拉伯一家三级医疗中心进行剖宫产术后引产的所有女性的记录。纳入标准为妊娠24至42周的单胎头位妊娠且既往有一次剖宫产史后进行引产的女性。排除标准为既往有两次或更多次剖宫产史、宫内死胎、臀位、引产、估计胎儿体重>4kg以及经典或低位垂直子宫切口。根据剖宫产术后引产次数比较这些女性的妊娠结局。 结果:在研究期间,1139名女性符合纳入标准。既往剖宫产术后引产次数为零、一、二、三次或更多次的女性人数分别为669名(58.7%)、237名(20.8%)、132名(11.6%)和101名(8.9%)。四组在年龄、国籍、孕次和产次方面存在统计学显著差异,但在剖宫产术后引产前的建档状态、BMI或血红蛋白水平方面无差异。剖宫产术后阴道分娩率从引产次数为零的72.9%显著增加(p<0.001)至引产次数为一次的93.3%、两次的93.9%以及三次或更多次的94.1%。 结论:既往剖宫产术后成功的阴道分娩与后续剖宫产术后引产中改善的母婴结局相关。
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