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| Analysis of the delivery mode of pregnant women after previous cesarean section and its influencing factors |
| Beijing Weeping Willow Hospital, Beijing, 100022 |
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Abstract To investigate the mode of delivery mode of pregnant women after previous cesarean section, and to analyze the influencing factors of the delivery mode. Methods: The clinical data of 496 women with pregnancy again after cesarean section from January 2016 to June 2022 were collected retrospectively. These pregnant women were divided into group A (women terminated pregnancy by vaginal delivery) and group B (women terminated pregnancy by cesarean section again) according to the delivery mode. The clinical indicators of the women were compared between the two groups, and the influence of the clinical indicators on their delivery mode was analyzed. Results: Among 496 pregnant women, 141 (28.4%) cases tried to vaginal delivery, and 114 cases had successful vaginal delivery, with the success rate of 80.9%, and the left 27 women converted to cesarean section. There were 382 (77.0%) cases delivered by cesarean section. Multiple logistic regression analysis showed that the initial intention of vaginal delivery, the history of natural delivery, and the uterine orifice opening >3cm when admission of hospital of the women were the favorable factors of their vaginal delivery, while the high prenatal body mass index (>30kg/m2), the pregnancy complications, the fetal position, and the fetal heart abnormalities of the women were the unfavorable factors of their vaginal delivery (all P＜0.05). The 1 min Apgar score (9.3±0.3 points) of the newborn after vaginal delivery was significantly higher than that (9.0±0.3 points) of the newborn after cesarean section (P＜0.05). There were no significant differences in the delivery outcomes, the birth weight of newborns, and the neonatal asphyxia rate between the women after vaginal delivery and the women after cesarean section (P＞0.05). Conclusion: In this survey, the caesarean section is the main delivery mode of the pregnant women after previous cesarean section. The degree of uterine orifice opening when admission of hospital, the history of natural delivery, the initial intention of vaginal delivery, the high prenatal body mass index, the complication of pregnancy, the fetal heart, and the fetal position of the women are all the factors affecting their vaginal delivery. So, the reasonable delivery mode should be chosen for the pregnant women according to the specific condition of each pregnant women in clinical obstetrics practice.
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