Predictive Factors For Successful Vaginal Birth After Cesarean

Objective: The purpose of this research is to explore the clinical factors that can be used for predicting the success of vaginal trials after cesarean section,providing an effective basis for the women with a history of cesarean section who chooses the mode of re-delivery,assessing the risk of delivery,and also preparing for establishing a suitable basis for Chinese.Methods: This study retrospectively analyzed the data of 162 pregnant women who underwent vaginal trial after cesarean section in our hospital from January 2016 to December 2017.Collected the following information,such as the age,(BMI),gravida and parity,interval between two cesarean sections,fetal weight estimation,and whether the previous cesarean section was in labor or not.General clinical conditions such as gestational weeks at labor,thickness of the myometrium at the uterine scar,cervical bishop score,premature rupture of the membranes,analgesia,and spontaneous parturient or not.Through retrospective analysis,analysis of single factor and analysis of multiple regression,the factors that may affect pregnancy outcomes were screened.K-S test,T test,Chi-square test or MannWhitney U test were used to test the possible factors.Finally,ROC curve was used to compare the predictive value,and Yoden index was used to determine the best predictive threshold.Results: The factors related to the outcome of vaginal delivery after cesarean section were: Bishop score,fetal weight estimation,the gestational weeks,whether spontaneous parturient or not,whether the previous cesarean section was in labor or not.In terms of the predicted value,the order was from large to small is the following: the Bishop score >gestational weeks > whether spontaneous parturient or not > fetal weight estimation > whether the previous cesarean section was in labor or not.When bishop’s score was greater than 6,gestational weeks were earlier than 39 weeks,fetal weight was estimated to be less than 3250 g,the previous cesarean section was in labor and spontaneous parturient,the success rate of vaginal trial delivery after cesarean section was higher.After Logistic regression,it was found that parturient gestational age,bishop score and spontaneous parturient were three independent factors influencing the success of vaginal trial after cesarean section.Conclusion: The above factors are beneficial to the success of vaginal delivery of the women with previous cesarean section and can reduce the rate of cesarean section...