Objective To evaluate the feasibility of vaginal delivery for subsequent pregnancy after the first cesarean section and investigate the related factors.
Methods The clinical data of 275 subsequent pregnancy after the first cesarean section in our hospital between January, 2015 and December, 2017 were reviewed. 133 cases of successfully vaginal delivery were assigned into vaginal birth after the first cesarean section group (VBAC group, observation group); 29 cases of failed vaginal delivery were assigned into failed trial of labor after the first cesarean section group (TOLAC group, failure group); 113 patients underwent directly the secondary cesarean section after admission were assigned into elective repeat cesarean section group (ERCS group). The age, gestational age, height, admission weight, weight change during pregnancy, cervical bishop score, amount of intrapartum hemorrhage, amount of postpartum hemorrhage at 24 hours and weight of newborn infants were compared among the three groups.
Results Compared with the failed group, the weight gain and bishop score of the VBAC group were significant, however, there was no significance in the other indicators. The VBAC group had a relatively smaller weight gain and higher bishop score. There was significant difference in the bishop score, the amount of intrapartum hemorrhage and the amount of postpartum hemorrhage at 24 hours between ERCS group and VBAC group, and the rest of the indicators were not significant. The VBAC group had a relatively high bishop score, a relatively small amount of intrapartum hemorrhage and amount of postpartum hemorrhage at 24 hours.
Conclusion The vaginal delivery can be conducted in women with subsequent pregnancy after the first cesarean section on the base of reasonable management during pregnancy and adequate assessment before delivery, which will appropriately decrease the rate of the cesarean section.
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