The Clinical Analysis of Vaginal Delivery After Cesarean Section, and Favorable factors for Vaginal Delivery

摘要

The different modes of delivery and outcomes of mother and child in pregnant women who had prior cesarean section, and analysed favorable factors of vaginal delivery. Summarized characteristics related to vaginal delivery after cesarean section, in order to guide the clinic, decrease the rate of cesarean section, and promote natural childbirth. We designed an prospective study of pregnant women had single prior cesarean section (segmental transverse uterine scar), singleton, cephalic presentation, and full-term pregnancy, the total number was 379. Observed the mode of delivery and analysed the beneficial factors of vaginal delivery. Baseline maternal data and perinatal outcomes were recorded for a descriptive, and multivariate analysis. A p value0.05 was considered significant. In this study, 87 cases pregnant women had trial of labor, 64 cases were vaginal delivery finally, the success rate was 73.56% (64/87). The maternal age, BMI index in pre-pregnancy and pregnancy, and blood loss were all smaller in women who had vaginal delivery than re-cesarean section (p0.05). The gestational weeks, cervical maturity, and interval time from the prior cesarean section were larger in women had vaginal delivery (p0.05). Multivariate analysis showed maternal age, BMI index in pre-pregnancy, cervical maturity and psychology were related to vaginal delivery. VBAC is feasible and safe. Most women had previous cesarean section refuse to trial of labor, often to choose re-cesarean section. So control the first indication of cesarean section is rather important in China. Attention women's weight before pregnant and psychology in pregnancy are significant. A management system of vaginal birth after cesarean were established, which to guide pregnant women more better and strengthen the education. In the meantime, have a good relationship and the trust between doctors and patients, pay attention to humanistic care, create a safe and comfortable environment to delivery should not be ignored.