| Objective: To explore the best selection on delivery of subsequent pregnancy after the first cesarean section and encourage the Vaginal birth after ceasarean(VBAC). Grasp the cesarean section indication correctly in order to reduce the rate of repeat cesarean section and improve the quality of obstetrics.Method: A retrospective analysis of 460 cases with secondary pregnancy afte the first cesarean section from 2000 to 2014 in our hospital. To select those wemen who dilivery through the Vaginal birth as VBAC group, and through a secondary cesarean section with a simple surgical indication of uterine scar as ERCS group.Finnally to choose those vaginal birth with noncesarean wemen in random as the VBNC group.Comparing the difference of maternal and fetal outcomes between those 3 groups. And to discuss the influence of the time of first cesarean on the blood loss during the repeat cesarean section.Result:1. The rate of repeat cesarean section in our hospital is very high,most wemen choose it with a simple surgical indication of uterine scar2. VBAC is better than ERCS in saving the hospitalization time,fewer blood loss and the costs in hospital.3. There is no significant difference between VBAC and VBNC in hospitalization,blood loss, incision healing, fetus’ weight and Apgar score.4. The influence of the time of first cesarean on the blood loss during the repeat cesarean section is small.Conclusion:1. The rate of secondary cesarean section is high, and the VBAC is low.2. VBAC has shorter hospitalization time, cost and fewer blood loss than ERCS;3. The risk of uterine rupture during vaginal delivery after a cesarean section is low.And it’s safe and feasible in corresponding medical conditions and clilicians’ carefully observation. |
