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| The pregnancy outcomes of women with history cesarean section after vaginal delivery and its correlation with scar thickness of women |
| Yiling District Maternal and Child Health Care and Family Planning Service Center of Yichang City, Hubei Province, 443100 |
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Abstract To analyze the pregnancy outcomes of women with history cesarean section after vaginal delivery (VBAC), and to explore its correlation with scar thickness of women. Methods: From January 2016 to May 2018, 159 pregnant women with history cesarean section who underwent vaginal trial delivery (TOLAC) were divided into two groups according to the thickness of scar tissue measured by ultrasound. The scar thickness of women in group A (85 cases with scar uterus grade Ⅰ) was 3-7mm, and that in group B (74 cases with scar uterus grade II) was 2-3mm. And another 120 pregnant women without history cesarean section who also experienced vaginal delivery were selected in group C. The pregnancy outcomes of women were analyzed and compared among the three groups. The success rate of VBAC of pregnant women was analyzed and compared between group A and group B. Results: The success rate of TOLAC of women in group A and group B was 66.7%. There were no significant different in the total time of labor, rates of postpartum hemorrhage, postpartum hemorrhage volume, hospitalization time of women, and neonatal weight, Apgar score, and complications, and rate of neonate transferred to pediatric department between the women with vaginal delivery successfully and women with TOLAC failure (P>0.05). In group A and group B, the gestational age, pre-pregnancy BMI index, gestational age, and neonatal weight of women with vaginal delivery were significant lower than those of women with TOLAC failure (P<0.05), but the muscular thickness of the lower uterine of women with vaginal delivery was significant higher than that of women with TOLAC failure (P<0.05). The success rate of vaginal delivery (87.1%) of women in group A was significant higher than that (43.2%) of women in group B (P<0.05). Conclusion: The pregnant women with history cesarean section experienced TOLAC is safety, but the medical pointer of TOLAC should be strict. Women with scar tissue thickness ≥ 2mm is safety for vaginal delivery, and the thicker the scar tissue, the higher the success rate of delivery. The scar tissue thickness of uterus can be as one of evaluation indication of TOLAC.
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