Paul R H, Phelan J P, Yeh S Y
Am J Obstet Gynecol. 1985 Feb 1;151(3):297-304. doi: 10.1016/0002-9378(85)90290-x.
The increasing incidence of cesarean birth has become quite controversial. The practice of delivering virtually all women with a prior cesarean section by repeat cesarean section is open to debate. In a large institutional practice, with rapid availability of all support services, selective attempts to deliver women vaginally, after a prior cesarean section, is appealing. A prospective 1-year study on all patients with a prior cesarean delivery commenced July 1, 1982. There were 1209 patients, of whom 751 (62%) underwent a trial of labor and 614 (82%) achieved vaginal delivery. There was no maternal mortality or perinatal mortality attributed to the trial of labor process. Oxytocin usage occurred in 38% of this population. The incidence of uterine rupture and scar dehiscence was similar in the various study subgroups. The overall group of women undergoing a trial of labor had significantly fewer postpartum complications and shorter hospital stays.
剖宫产率的不断上升已颇具争议。几乎所有曾行剖宫产的女性再次剖宫产的做法值得商榷。在大型医疗机构中，由于所有支持服务都能迅速到位，对于曾行剖宫产的女性选择性地尝试经阴道分娩颇具吸引力。1982年7月1日开始了一项针对所有曾行剖宫产患者的为期1年的前瞻性研究。共有1209例患者，其中751例（62%）接受了试产，614例（82%）实现了阴道分娩。试产过程中没有孕产妇死亡或围产期死亡情况。该人群中有38%使用了缩宫素。子宫破裂和瘢痕裂开的发生率在各个研究亚组中相似。接受试产的女性总体产后并发症明显较少，住院时间也较短。
