Objective:To explore clinical indications of pregnant women for vaginal delivery after previous cesarean section,and to analyze the influence factors of vaginal delivery successfully.Methods:In this retrospective study,clinical data of 157 pregnant women with previous cesarean section were collected.Among these women,76 women undergone vaginal delivery successfully and 81 women undergone cesarean section again.The clinical related indications of pregnant women for vaginal delivery were compared between the two groups.Logistic regression was used for multiple factors analysis.Results:The average thickness of scar in the lower uterine segment of women(3.42mm±0.54mm) in vaginal delivery group was significant thicker than that of women(3.05mm± 1.03mm) in cesarean section again group (P＜0.05).There was significant difference in time interval from the last cesarean section of women between the two groups (P＜0.05).The volume of intrapartum bleeding,neonatal Apgar score and rate of postpartum complication had no significant difference between the two groups (P＞0.05).Multiple factors analysis showed that time interval from the last cesarean section (OR=4.40) and the thickness of the lower uterine segment (OR =1.86) were the important factors for vaginal delivery successfully after previous cesarean section.Conclusion:Interval 2 years after previous cesarean section and the thickness of the lower uterine segment more than 3mm are safety factors for vaginal delivery successfully.Delivery mode of pregnant women after previous cesarean section should be paid more attention to,and vaginal delivery should be tried If eligible.%目的:探讨剖宫产再孕阴道分娩的临床指标选择及成功分娩影响因素.方法:回顾性收集本院剖宫产后再孕产妇临床资料共1 57例,其中阴道分娩成功76例,剖宫产分娩81例.对比分析两组孕妇相关指标差异,使用logistic回归进行多因素分析.结果:子宫下段瘢痕厚度、距离上次剖宫产时间在两组间有差异(P＜0.05),阴道分娩组子宫下段瘢痕厚度(3.4mm±0.5mm)高于剖宫产组(3.1mm±1.0mm);产时出血量、新生儿Apgar得分、产后并发症发生率与剖宫产组未见统计学差异(P＞0.05);再分娩间隔时间(OR =4.40)、子宫下段瘢痕厚度(OR=1.86)是剖宫产再孕阴道分娩成功的影响因素.结论:间隔时间≥2年、子宫下段瘢痕厚度＞3mm是剖宫产再孕阴道分娩的安全因素.对剖宫产再孕的分娩方式应视产时情况而定,条件允许情况下可以采取经阴道方式进行试分娩.
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