Abstract:Objective To explore the relationship between the outcomes of trial of labor after cesarean (TOLAC) and uterine scar associated factors.Methods We retrospectively analyzed the clinical data of 65 pregnant women who had had a previous cesarean delivery and chose trial of labor admitted to our hospital from January 2015 to December 2015. The relationship between the outcomes of TOLAC and the type of incision of lower uterine segment, birth interval, and the thickness of scar of uterine segment was analyzed.Results Among the 59 women with TOLAC, the successful rate was 90.8%, with a rate of 96.6% for preterm births and a rate of 86.1% for term births. For those with a low transverse uterine incision, the rate was 79.7%, compared with 20.3% for those with a low vertical uterine incision. Vaginal birth was 8.5%, 74.6%, and 16.9% for those with a birth interval of 2 years or shorter, 2years to 10 years, and 10 years or longer, respectively. Vaginal birth was 8.5% for scar thickness of <1.0 mm compared with 91.5% for scar thickness of 1.0 mm or above. Similarly, vaginal birth was 18.6% for scar thickness of < 2.0 mm compared with 81.4% for scar thickness of 2.0 mm or above.Conclusion The assessment of TOLAC should follow the principle of individualization. TOLAC may be considered with the following indications:preterm birth, low vertical uterine incision, birth interval in 18-24 months or 10 or more years, and scar thickness of 3.0 mm or below.
李静, 燕美琴, 王竞, 刘亦娜. 剖宫产术后再次妊娠阴道试产结局与子宫瘢痕相关因素的关系[J]. 中国生育健康杂志, 2016, 27(6): 514-518.
LI Jing, YAN Meiqin, WANG Jing, LIU Yina. The relationship between the outcomes of trial of labor after cesarean and uterine scar associated factors. Chinese Journal of Reproductive Health, 2016, 27(6): 514-518.
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