Ottawa Hospital Research Institute, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H8L6, ON, Canada.
Department of Obstetrics and Gynecology, McMaster University, 501 Smyth Road, Ottawa, K1H8L6, ON, Canada.
Best Pract Res Clin Obstet Gynaecol. 2022 Mar;79:95-106. doi: 10.1016/j.bpobgyn.2021.12.003. Epub 2021 Dec 17.
The current evidence favours trial of labour after one caesarean in the absence of any other contraindications, recognizing that risks with both trial of labour after caesarean (TOLAC) and elective repeat caesarean section (ERCS) birth are relatively uncommon. When the need for induction of labour (IOL) following a previous caesarean arises, shared decision-making should be based on the current available evidence. This approach, however, needs to be tailored, taking into account the individual's history, initial examination and response to the ongoing process of induction to optimize the maternal and foetal outcomes. This paper aims to review the evidence and provide guidance on decision making surrounding labour induction in a pregnancy following a prior caesarean or uterine surgery.
目前的证据支持在没有其他禁忌症的情况下，对第一次剖宫产术后尝试阴道分娩，因为剖宫产术后阴道分娩（TOLAC）和选择性重复剖宫产（ERCS）的风险相对较少。当先前剖宫产术后需要引产时，应基于当前可用的证据进行共同决策。然而，这种方法需要根据个人的病史、初步检查和对正在进行的引产过程的反应进行调整，以优化母婴结局。本文旨在回顾相关证据，并为既往剖宫产或子宫手术后妊娠的引产决策提供指导。
