Analysis Of The Characteristics Of Vaginal Delivery In Scarred Uterus With Second Pregnancy And The Factors Affecting The Success Of Delivery

Objective:To analyse again scar uterus pregnancy Vaginal delivery(Vaginal birth after previous cesarean,VBAC)labor characteristics,summarizes the related factors that affect the successful delivery,in order to provide certain scientific basis for clinical treatment of scar uterus pregnancy again correct cases of Vaginal delivery.Methods:In January 2018-December 2018 from 210 cases of women as the object of this study,the scar uterus vaginal delivery of 70 cases of maternal pregnancy again,as a group,foot menstrual first-timer,a total of 70 cases of maternal vaginal delivery,1 set as control group,again after full term by producing a total of 70 cases of maternal vaginal delivery,as a control group two groups,the clinical data of three groups,delivery situation for recording,comparison and analysis of the results.Results :(1)the average age of the observation group was(31.52±3.79)years old,the average time between the last cesarean section was(5.21± 2.58)years old,and the average age of the control group 1(28.11±1.71)years old.The average age of 70 parturients in the control group 2 was(31.24 ±2.75)years.The age difference between the observation group and the control group 2 was not significant(P>0.05).The age difference between the observation group and the control group 1 was significantly higher(P<0.05).(2)there was no significant difference in the amount of blood loss during delivery between the observation group,control group 1 and control group 2(P>0.05),and no significant difference in 5-minute Apgar score between the observation group,control group 1 and control group 2(P > 0.05).(3)the postpartum bleeding rate of the observation group was 4.29%,that of the control group 1 was 2.86%,and that of the control group 2 was 0.00%.There was no statistically significant difference in the postpartum bleeding rate of the three groups(P>0.05).(4)the incidence of placental adhesion,threatened uterine rupture and neonatal asphyxia in the observation group was slightly higher than that in the control group 1 and the control group 2,but the difference was not statistically significant(P>0.05).(5)among the 4 cases of Trial of labor after cesareansection(TOLAC)failure,2 were due to fetal distress,1 was due to the stagnation of labor activity,and 1 was due to fetal position abnormalities.(6)the cervical score of the 4 TOLAC failure groups was 6.66±1.21 points,and the neonatal weight was 3748.52±126.32 g.The cervical score of the 66 TOLAC success groups was 9.09±3.07 points,and the neonatal weight was 3316.95±75.42 g.Conclusion:(1)the total labor process of vaginal parturient women with scar uterine repregnancy is between primipara and multipara.In the clinical management of scar uterine and vaginal delivery,it is necessary to consider the special characteristics of labor process,closely observe the progress of labor process,and timely give intervention countermeasures.(2)fetal weight and cervical score are the two main factors influencing the success of scar vaginal delivery.(3)scar uterine perineal delivery will not significantly increase the possibility of postpartum complications,so as long as the puerpera meets the conditions of trial birth,it should be fully tried to reduce the rate of cesarean section and ensure the safety of mother and baby.