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| Influence factor analysis of vaginal trial delivery outcomes of subsguent pregnancy of women with scar uterus after cesarean section |
| Hangzhou Obstetrics and Gynecology Hospital, Hangzhou Maternal and Child Health Care Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310007 |
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Abstract To explore the relevant factor of the outcomes of the vaginal trial delivery of subsguent pregnancy of women with scar uterus after cesarean section. Methods: The clinical data of 218 pregnant women with scar uterus after cesarean section who had tried vaginal delivery were analyzed retrospectively. These women were divided into group A (32 women with failure vaginal delivery) and group B (186 women with successful vaginal delivery) according to the outcomes of trial vaginal delivery. Logistic regression model analysis was used to analyze the influencing factors of the vaginal trial delivery outcomes of the second pregnancy of women with scar uterus after cesarean section. Results: There were 186 (85.3%) women with successful vaginal trial delivery in the total 218 women. Multivariate logistic regression analysis showed that, the age ≥35 years old (OR=2.371, 95% CI1.401-4.383), the prenatal body mass index (BMI) ≥30 kg/m2 (OR=4.805, 95% CI 2.636-7.209), the lower uterine segment muscle layer thickness <4 mm (OR=3.636, 95% CI 1.472-5.810), the time from the last delivery <3 years (OR=1.827, 95% CI 1.186-3.461), the neonatal weight ≥3.5 kg (OR=2.850, 95% CI 1.295-5.116), and the amniotic fluid pollution (OR=2.613, 95% CI 1.053-4.875) were the influence factors of vaginal trial delivery failure of the second pregnancy of women with scar uterus after cesarean section (P＜0.05). Conclusion: Advanced age, prenatal obesity, insufficient lower uterine muscle thickness, short delivery interval, excessive infant BMI, and amniotic fluid pollution of the women with scar uterus after cesarean section have adverse influence on their vaginal trial delivery outcomes of the second pregnancy.
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