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剖宮產後陰道試產的臨床分析
Clinical Analysis of Vaginal Birth after Cesarean Delivery (VBAC) of the 748 Women in Macau
摘要
目的：探討疤痕子宮陰道試產的可行性和選擇指徵，並進行安全性評估。方法：回顧分析自本院2015年7月～2017年6月748例疤痕子宮再次妊娠孕婦的分娩方式；並將其中192例經陰道分娩的產婦（觀察組）與200例首次經陰道分娩的初產婦（實驗組）作對比，記錄並比較產時出血量、住院天數及新生兒1min Agpar評分。結果：疤痕子宮再次妊娠孕婦經陰道試產成功共192例，佔疤痕子宮再次妊娠分娩量25.66%；陰道試產成功率為73.8%。觀察組與對照組比較產時出血量、住院時間、新生兒Agpar 1min評分均無統計學意義（P>0.05）。結論：嚴格掌握適應症、做好產程監護，疤痕子宮陰道試產對母嬰是安全的，且成功率高。
並列摘要
Objective. To evaluate the practice of trial of labour after Cesarean (TOLAC) and its selection criteria. Methods. Retrospective analysis of the delivery mode of 748 women with a prior cesarean section from July 2015 to June 2017 in Kiang Wu Hospital was undertaken. Several clinical parameters of the 192 cases of VBAC (Observation group) and 200 cases of primiparous vaginal delivery (Control group) were observed and compared. Results. There were 192 cases (25.66%) of successful TOLAC from the 748 cases. The success rate of VBAC was 73.8% (192/260). The blood loss during delivery, the duration of hospitalization and the 1-minute Apgar score of the newborns between two groups were not statistically significant (p >0.05). Conclusion. By applying strict selection criteria and with cautious monitoring of labor, TOLAC is safe for both mothers and neonates.