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| Clinical analysis of 151 cases of trial of labor after cesarean section |
| YANG Yuxia1 WANG Xiaoxin2 ZHANG Chengyan2 ZOU Liying2▲ |
1.Tangshan Maternal and Child Health Care Hospital, Hebei Province, Tangshan 063000, China;
2.Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China |
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Abstract Objective To explore the factors influencing the success rate of vaginal delivery after cesarean section. Methods One hundred and fifty-one pregnant women after cesarean section and voluntary vaginal delivery, who did their prenatal care in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2016 to June 2017, were involved. They were divided into the success group and the failure group according to the outcome of trial of labor after cesarean (TOLAC). The general situation and prognosis of two groups were compared and analyzed. Results In 151 cases of TOLAC, 125 cases were successfully delivered (success group) and 26 cases were transferred to cesarean section after failure (failure group). The success rate was 82.78%. There was 1 uterine rupture and the uterine rupture rate was 0.66%. There was no significant difference in the pre-pregnancy body mass index (BMI), ante partum BMI, the gravidity, the parity, thickness of the lower uterine segment and the interval time of the previous cesarean section between two groups (P ＞ 0.05). The age of success group was highly significantly higher than that of failure group (P ＜ 0.01). After removing preterm birth cases, there was no statistically significant difference in the age between two groups (P ＞ 0.05). The induction rate of success group was lower than that of failure group (P ＜ 0.01). There was no significant difference in postpartum 2 h blood loss and neonatal body weight between the two groups (P ＞ 0.05). The 1 min Apgar score of the success group was significantly higher than that of the failure group (P ＜ 0.05). Conclusion Age, the gravidity, the parity, pre-pregnancy BMI, ante partum BMI, thickness of lower uterine segment before delivery and the interval time of previous cesarean section do not affect the outcome of TOLAC. The inability to spontaneous labor and the intervention of induced labor may be related to the decrease of the success rate of vaginal delivery.
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