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| The characteristics of labor of women with vaginal delivery after cesarean and the risk factors of trial delivery failure |
| The First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital), Jinan, Shandong Province, 250014 |
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Abstract To analyze the characteristics of labor of women with vaginal delivery after cesarean (VBAC), and to explore the high risk factors of the trial delivery failure. Methods: The clinical data of 168 women who had experienced the try of labor after cesarean (TOLAC) in group A, 120 primipara after vaginal delivery in group B, and 120 multiparous in group C from January 2018 to January 2020 were collected retrospectively. And in group A, the women were divided into group A1 (women with VBAC success) and A1 (women with VBAC failure). The difference of labor time of women labor in group A1 was compared, and the risk factors of failure of vaginal delivery were analyzed. Results: The time of active stage of labor of women in group A1 was significant longer than that of women in group C, but was significant less than that of women in group B. The time of the second stage of labor of women in group A1 and group B was significant longer than that of women in group C (P＜0.001), but there was no significant difference between group A1 and group B. There were no significant difference in the time of latency stage and the third stage of labor among group A1, group B and group C (P＞0.05). The proportion of TOLAC failure of women with age≥35 years old or birth interval≥5 years was significant higher, the proportion of TOLAC failure of women with high school education level was significant higher than that of women with middle school or less, college, or undergraduate or above education level (all P＜0.001). There was no statistical significant difference in the proportion of TOLAC failure between the women with ≥39 gestational weeks when delivery and the women with <39 gestational weeks when delivery, and between the women with cesarean section before near the time of labor and the women with previous transfer to cesarean section (P＞0.05). The women with≥35 years old was an independent risk factor of TOLAC failure (P＜0.05), but birth interval≥5 years and education level were not independent risk factors of TOLAC failure (P＞0.05). Conclusion: The labor time of primipara who wanting VBAC is not equal to that of multiparous, and advanced age increases the risk of TOLAC failure, which should be paid more attention to in clinical practice.
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