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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Obstetric outcome associated with trial of labor in women with three prior cesarean delivery and at least one prior vaginal birth in an area with a particularly high rate of cesarean delivery
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Obstetric outcome associated with trial of labor in women with three prior cesarean delivery and at least one prior vaginal birth in an area with a particularly high rate of cesarean delivery

机译：在剖宫产发生率特别高的地区中，有三次剖腹产和至少一次阴道分娩的妇女进行分娩试验的产科结果

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Objective: The objective of this study is to evaluate maternal and neonatal outcomes associated with trial of labor after cesarean (TOLAC) in women with three prior cesarean delivery (CD) and at least one prior vaginal delivery.Methods: This is a retrospective study using data collected from clinical records of women three prior CD and at least one prior vaginal delivery who were referred to our unit. Maternal and perinatal outcomes were compared between women with three prior CD who underwent TOLAC and those who underwent planned repeated CD (i.e. control group). The primary outcome was a composite of maternal complications including at least one of the followings: need for blood transfusion, uterine rupture, hysterectomy, and admission to intensive care unit.Results: Fifty singleton gestations with three prior CD at with at least one prior vaginal birth were analyzed. Of them, 10 accepted to undergo TOLAC. Of the 10 women who underwent TOLAC, nine had vaginal birth and one had CD for non-reassuring pattern. We found no significant differences in the primary outcome, in need for blood transfusion, in the incidence of uterine rupture, hysterectomy, and admission to intensive care unit comparing TOLAC group with controls.Conclusion: TOLAC in women with three prior CD and at least one prior vaginal delivery is a viable option and is not associated with higher risk of adverse maternal or fetal outcomes.
机译：目的：本研究的目的是评估三例剖宫产（CD）和至少一例阴道分娩的妇女进行剖宫产后分娩试验（TOLAC）的母亲和新生儿结局。数据从女性的临床记录中收集，这些女性的三个先前的CD和至少一个先前的阴道分娩被转介到我们单位。比较了三名接受TOLAC的既往CD患者和计划重复进行CD的妇女（即对照组）的产妇和围产期结局。主要结局是孕产妇并发症的综合，包括以下至少一项：输血，子宫破裂，子宫切除术和重症监护病房的需要。结果：50例单胎妊娠，3例先验CD，至少1例先验阴道出生情况进行了分析。其中，有10人接受了TOLAC。在接受TOLAC治疗的10例妇女中，有9例阴道分娩，其中1例具有CD的非安慰性模式。与TOLAC组和对照组相比，我们发现在需要输血，子宫破裂，子宫切除术和重症监护病房入院的主要结局方面无显着差异。结论：TOLAC在有3例既往CD和至少1例CD的女性中事先阴道分娩是一个可行的选择，并且与母体或胎儿不良结局的较高风险无关。

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