[The outcome of trial of labor after cesarean section].
[The outcome of trial of labor after cesarean section].
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DOI：
10.3760/cma.j.issn.0529-567x.2016.10.008
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发表时间：
2016-10-25
期刊：
影响因子：
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通讯作者：
Zhu, B
中科院分区：
文献类型：
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作者：
Qu, Z Q;Ma, R M;Zhu, B
目的：探讨剖宫产术后试产（TOLAC）的效果。方法： 2013年7月至2016年6月在昆明医科大学第一附属医院共进行614例TOLAC，其中586例既往剖宫产单胎妊娠（胎龄≥28周）患者进行回顾性研究。比较剖宫产后阴道分娩（VBAC）组（481例）、TOLAC失败组（105例）和择期再次剖宫产（ERCS）组（1 145例）的孕产妇和新生儿结局。采用多元logistic回归分析确定入住新生儿重症监护病房（NICU）的危险因素。结果：（1）2013年7月至2016年6月TOLAC率为29.62%（614/2 073），VBAC率为82.6%（507/614）。 VBAC使剖宫产率降低3.147%（507/16 112）。（2）产妇不良结局比较：VBAC组产后出血量为（431±299）ml，产后发热率为6.4%（31/481），新生儿出生体重为（3 085±561）g，大于胎龄率为2.9%(14/481)。均显着低于TOLAC失败组和ERCS组(P
Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. The maternal and neonatal outcomes among the vaginal birth after cesarean(VBAC)group(481 cases), failed TOLAC group(105 cases)and the elective repeat cesarean section(ERCS)group(1 145 cases)were compared. Multiple logistic regression was used to determine the risk factors of admission to neonatal intensive care unit(NICU). Results: (1)The TOLAC rate was 29.62%(614/2 073)from July 2013 to June 2016, and the VBAC rate was 82.6%(507/614). The cesarean section rate was reduced by VBAC by 3.147%(507/16 112).(2)The comparison of adverse maternal outcomes: in the VBAC group, the postpartum hemorrhage volume was(431±299)ml, the rate of postpartum fever was 6.4%(31/481), the birth weight of the neonates was(3 085± 561)g, and the rate of large for gestational age was 2.9%(14/481). All were significantly lower than those in the failed TOLAC group and the ERCS group(P