Clinical analysis of different delivery modes in the second pregnancy after previous cesarean section and maternal and neonatal outcomes

SUN Fang; WANG Zheng

doi:10.3969/j.issn.1002-7386.2018.13.007

Abstract：Objective To investigate the different delivery modes in the second pregnancy after previous cesarean section as well as maternal and neonatal outcomes and complications. different delivery mode of repeated pregnancy after previous cesarean section and the incidence of complications of mother and infants. Methods The study was performed by means of retrospective case-control analysis. A total of 379 pregnant women with the second pregnancy after previous cesarean section and gestational weeks≥34 weeks were enrolled as subjects, in whom,there were 327 cases of repeated cesarean section (experimental group 1) and 52 cases of vaginal delivery (experimental group 2),moreover,the other 352 cases of non scarred uterus cesarean section were enrolled as control group 1,and 109 cases of non scarred uterus natural delivery were enrolled as control group 2. The delivery outcomes of puerpera were observed and compared among the four groups. Results There were no significant differences in maternal age, gestational weeks, neonatal body weight, 1 min Apgar scores and umbilical cord blood pH between experimental group 1 and control group 1 (P＞0. 05). The intraoperative bleeding volume in experimental group 1 was significantly larger than that in control group 1 (P＜0. 05). There were no significantly differences in maternal age, gestational weeks, neonatal body weight, duration of the second and third stage of labor, perineum tear at degreeⅠand degreeⅡbetween experimental group 2 and control group 2 (P＞0. 05). The postpartum 2h bleeding volume in experimental group 2 was significantly larger than that in control group 2 (P＜0. 05),moreover,there were significant differences in 1 min and 5min Apgar scores, umbilical cord blood pH and duration of the first stage of labor between the two groups (P＜0. 05). In addition the perineum incision rate and vaginal midwifery rate in experimental group 2 were significantly higher than those in control group 2 (P ＜0. 05), however, there were no significant differences in postpartum hemorrhage rate and neonatal asphyxia rate between the two groups (P＞0. 05). Conclusion The vaginal delivery in pregnant women with scarred uterus and the second pregnancy is superior to caesarean section,the latter is not the first choice,therefor,vaginal birth should be tried if pregnant women have no contraindication of vaginal delivery.