Causes of futerine rupture due to re-pregnancy after cesarean section

WANG Xiaohong; YU Shasha; FU Dongmei; CHEN Yehong; GUO Fangfang

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Medical Journal of the Chinese People Armed Police Forces ›› 2018, Vol. 29 ›› Issue (6) : 561-565.

ORIGINAL ARTICLES

Causes of futerine rupture due to re-pregnancy after cesarean section

WANG Xiaohong, YU Shasha, FU Dongmei, CHEN Yehong, GUO Fangfang

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Abstract

Objective To investigate the main causes and ways of prevention of uterine rupture caused by re-pregnancy after cesarean section.Methods A total of 412 cases of patients without absolute contraindications were selected for the first screening of pregnancy after cesarean section between October 2015 and October 2017.Results After a retrospective analysis of the samples, it was found that 215 cases implemented TOLAC (trial of labor after previous cesarean delivery).The rate of successful vaginal trial production was 72.56 %(156/215)in the 215 pregnancies,the rate of cesarean section was 27.44%(59/215),and the incidence of complete uterine rupture was only 0.47 % (1/215 ). According to the outcomes of trial of labor, these patients were divided into two groups: the second-time cesarean group and the vaginal delivery group. The bleeding volume in the second-time cesarean group was significantly larger than that of the vaginal delivery group,so there was statistically significant difference (P<0.01).After we compared these results with the sample data of 13 pregnant women with uterine rupture, we found that the common characteristics included such indexes as abnormalities of the fetal heart and uterine contraction.Conclusions The risk of TOLAC is very small.The age of pregnant women, macrosomia and scar thickness are not absolute contraindications, but in clinical practice, it is necessary to take into account the fetal heart and uterine contraction so as to improve the success rate of TOLAC and reduce the occurrence of uterine rupture.

Key words

trial of labor after previous cesarean delivery / uterine rupture / pregnancy outcomes / cardiac abnormalities

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WANG Xiaohong, YU Shasha, FU Dongmei, CHEN Yehong, GUO Fangfang. Causes of futerine rupture due to re-pregnancy after cesarean section[J]. Medical Journal of the Chinese People Armed Police Forces. 2018, 29(6): 561-565

References

[1] 朱逸博,李宏田,刘建蒙,等.剖宫产及孕妇要求剖宫产的流行状况[J].中国生育健康杂志,2012,23(1):76-78.
[2] 王　端,许媛媛.妊娠心理状况对分娩方式及妊娠结局的影响[J].中国妇幼保健,2016,31(1):46-47.
[3] 李彩虹,陈亚莉,李小会,等.分娩全程予以心理护理对妊娠结局的影响[J].国际精神病学杂志,2016,43(4):735-738.
[4] 中华医学会妇产科学分会产科学组.剖宫产术后再次妊娠阴道分娩管理的专家共识(2016)[J].中华妇产科杂志,2016,51(8):561-563.
[5] 张辰晨,刘　玲.痕子宫再次妊娠阴道试产的可行性、条件及其影响因素[J].武警医学,2016,27(7):746-750.
[6] 李博雅,杨慧霞.剖宫产后阴道分娩相关问题[J].中国实用妇科与产科杂志, 2016,32(8):748-753.
[7] 曾　榕,丁爱华.孕妇心理因素对分娩方式及妊娠结局的影响[J].中国健康心理学杂志,2017,25(12):1812-1814.
[8] Metz T D ,Scott J R,Smot M, et al.Contemporary management of VBAC[J].Clin G,2012,55(4):1026-1032.
[9] 何承晋,漆洪波.美国妇产科医师学会《前次剖宫产后阴道分娩指南》2015版要点解读[J].中国实用妇科与产科杂志, 2016,32(11):1083-1087.
[10] 王　阳,丁荣楣,马丽君,等.2012 至 2016 年剖宫产率及手术指征的变化趋势分析[J].河北医药, 2017,39(23):3656-3658.
[11] 申恒春.剖宫产术后瘢痕子宫再次妊娠 93 例分娩方式探讨[J].实用妇产科杂志,2013,29(3):234-236.
[12] 金敏丽.140 例剖宫产后疤痕子宫再次妊娠分娩方式的临床分析[J].中华全科医学, 2014,12(10):1614-1616.
[13] Baksu B,Davas I,Aga E,et al. The effect of mode of delivery on postpartum sexual functioning in primiparous women[J].Inu J, 2014, 18(4):401-406.
[14] 武书丽,朱　华.分娩方式对新生儿出生后 3 天内肠道菌群的影响[J].儿科药学杂志,2017,23(12):4-6.
[15] Holmgren C,Scott J R,Porter T F,et al. Uterine rupture with attempted vaginal birth after cesareandelivery:decision-to-delivery time and neonatal outcome[J].Obst G,2012,119(4):725-731.
[16] 王彩霞,郭培奋,胡晴丽,等.剖宫产术后不同年限子宫瘢痕的组织学与力学特征观察[J].武警医学,2015,26(9):900-903.
[17] Cahill A G,Waterman B M,Stamilio D M,et al. Higher maximum doses of oxytocin are associated with an unacceptably high risk for uterine rupture in patients attempting vaginal birth after cesarean delivery[J].Am J Obstet G,2008,199(32):120-125.
[18] Harper L M,Cahill A G,Boslaugh S,et al. Association of induction of labor and uterine rupture in women attempting vaginal birth after cesarean: a survival analysis[J].Am J Obstet G,2012,206 (1):51-55.
[19] Society of obstetricians and gynaecologists of canada. SOGC clinical practice guidelines. Guidelines for vaginal birth after previous caesarean birth. Number 155 (Replaces guideline Number 147) [J]. Int J G,2005,89(3):319-331.
[20] Galyean A M,Lagrew D C,Bush M C,et al.Previous cesarean section and the risk of postpartum maternal complications and adverse neonatal outcomes in future pregnancies[J].J Perinatol,2009,29(11) :726-730.
[21] 张　怡,吴新华.威廉姆斯产科学手册[M].21版.长沙:湖南科学技术出版社,2006:204.
[22] Spong C Y,Landon M B,Gilbert S,et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery[J].Obstet Gynecol,2007,110(4) :801-807.