Silberstein T, Wiznitzer A, Katz M, Friger M, Mazor M
Division of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Obstet Gynecol Reprod Biol. 1998 May;78(1):29-32. doi: 10.1016/s0301-2115(98)00005-0.
Although a trial of labor after cesarean section (VBAC) is successful and relatively safe, few studies have directly addressed the necessity of routine transcervical revision of uterine scar after prior cesarean section. We performed a longitudinal study of 3469 women who had VBAC. In all patients, uterine scar integrity was examined immediately after placental expulsion. The detection rate of uterine scar dehiscence or rupture was 0.23% (8/3469). Only one woman with complete uterine rupture needed immediate laparotomy for severe hemorrhage. Out of seven patients (0.2%), who had evidence of uterine dehiscence, three underwent explorative laparotomy. In conclusion, the potential benefit of routine examination of uterine scar after VBAC is doubtful. Transcervical revision should be performed only in symptomatic patients.
尽管剖宫产术后试产（VBAC）成功率较高且相对安全，但很少有研究直接探讨剖宫产术后常规经宫颈修复子宫瘢痕的必要性。我们对3469例进行VBAC的女性进行了一项纵向研究。在所有患者中，胎盘娩出后立即检查子宫瘢痕完整性。子宫瘢痕裂开或破裂的检出率为0.23%（8/3469）。只有一名子宫完全破裂的女性因严重出血需要立即进行剖腹手术。在七名有子宫裂开证据的患者（0.2%）中，三名接受了剖腹探查术。总之，VBAC术后常规检查子宫瘢痕的潜在益处值得怀疑。仅应对有症状的患者进行经宫颈修复。
