Discussion of obstetrical management approach for repeated pregnancy with scarred uterus / 中国现代医生

ABSTRACT

Objective To explore the selection of obstetrical management approach for repeated pregnancy with scarred uterus. Methods Clinical data of 112 puerpera with scarred uterus for repeated pregnancy were retrospectively ana-lyzed. They were admitted to our hospital and were given cesarean section or myomectomy from March 2014 to Febru-ary 2015. 981 cases with repeated cesarean section were collected at the same time. The selection of obstetrical man-agement approach for repeated pregnancy with scarred uterus was analyzed. Results Among 112 patients with vaginal trial labor, 107 patients were successful, and the successful rate was 95.5%. Among them, 97 patients were natural de-livery, 10 patients were vaginal assistant delivery (3 cases of obstetrics forceps, 5 cases of vacuum extractor of fetal head and 2 cases of breech delivery), and 5 patients were cesarean section, there were 986 cases with repeated cesarean section. There were no statistically significant differences of pregnant women's age, gestational weeks, neonatal blood gas and morbidity rate of puerperium compared between the two groups of delivery modes of repeated pregnancy with scarred uterus and repeated cesarean section(P>0.05); the amount of bleeding, neonatal body weight and length of stay in the puerpera with vaginal delivery were all significantly lower than those in the puerpera with cesarean section, and the differences were statistically significant(P<0.05). Conclusion The pregnant women with repeated pregnancy in scarred uterus who meet the criteria of vaginal delivery should be given the opportunity of vaginal trial delivery. The advantages of vaginal trial delivery are more than disadvantages, and the risk of uterine rupture is not higher.