Maternal complications with vaginal birth after cesarean delivery: A multicenter study
Maternal complications with vaginal birth after cesarean delivery: A multicenter study
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DOI：
10.1016/j.ajog.2005.04.002
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发表时间：
2005-11-01
影响因子：
9.8
通讯作者：
Ratcliffe, SJ
中科院分区：
文献类型：
--
作者：
Macones, GA;Peipert, J;Ratcliffe, SJ
目的：本研究旨在确定在各种医院环境中尝试剖宫产 (VBAC) 的妇女子宫破裂的发生率和危险因素。研究设计：我们在一组既往接受过剖宫产的妇女中进行了一项病例对照研究，以确定尝试 VBAC 的妇女子宫破裂的发生率和危险因素。结果：尝试 VBAC 的妇女子宫破裂的发生率为 9.8%。 1000. 先前的阴道分娩与较低的子宫破裂风险相关（调整后的比值比 [OR] = 0.40 95% CI 0.20-0.81）。尽管单独使用前列腺素与子宫破裂无关，但连续使用前列腺素和催产素与子宫破裂相关（调整后 OR = 3.07，95% CI 0.98-9.88）。结论：既往剖腹产的女性应接受 VBAC，并且应鼓励既往剖腹产和阴道分娩的女性接受 VBAC。尽管其他研究表明应避免使用前列腺素，但我们建议避免需要序贯药物的诱导。 (C) 2005 Mosby, Inc. 保留所有权利。
Objective: This Study was undertaken to determine incidence and risk factors For uterine rupture in women attempting vaginal birth after cesarean delivery (VBAC) in a wide range of hospital settings.Study design: We pet-formed a case-control study nested within a cohort of women who have had a prior cesarean to determine the incidence and risk factors for uterine rupture in women attempting VBAC.Results: The incidence rate Of Uterine rupture in those who attempt VBAC was 9.8 per 1000. A prior vaginal delivery was associated with a lower risk Of Uterine rupture (adjusted odds ratio [OR] = 0.40 95% CI 0.20-0.81). Although Prostaglandins alone were not associated with uterine rupture, sequential use of prostaglandin and pitocin was associated with uterine rupture (adjusted OR = 3.07, 95% CI 0.98-9.88).Conclusion: Women with a prior cesarean should be offered VBAC, and women with a prior cesarean and prior vaginal delivery should be encouraged to VBAC. Although Other Studies have suggested that prostaglandins should be avoided, We Suggest that inductions requiring sequential agents be avoided. (C) 2005 Mosby, Inc. All rights reserved.