NHẬN XÉT KẾT QUẢ SINH THƯỜNG TRÊN SẢN PHỤ CÓ SẸO PHẪU THUẬT LẤY THAI TẠI BỆNH VIỆN 198

Abstract

Objectives: Review the results of vaginal birth after cesarean section at hospital 198. Subjects and methods: All pregnant women with once previous cesarean section admitted to hospital 198 have had indication to trial of labor from 2018 to 2022. Results: The duration of pushing was mainly from 30 to 60 minutes with a rate of 49.6%. There were 6 cases of no pushing, including 03 women with cervix that did not progress and 03 women with signs of fetal distress. Successful vaginal birth accounts for 84.2% and cesarean section conversion accounts for 15.8% (causes include: uterine rupture accounts for 2.3%, head failure accounts for 4.5%, cervical non-progression accounts for 4.5%). 4.5%, threatened uterine rupture accounted for 2.3% and fetal failure accounted for 2.3%). Complications and complications: Postpartum bleeding (4.5%); There were 3 cases of uterine rupture (2.25%), all were treated conservatively, there was only 01 case of neonatal death, accounting for 0.75%, there was 01 case of neonatal asphyxia (0.75%), 01 case of neonatal death. Infectious cases (0.75%), 03 cases with low Apgar (2.25%), no maternal death. Factors that have a statistically significant impact on vaginal birth outcomes include: Total time of labor monitoring (OR: 1.6; 95% CI: 1.2 - 2.2); Use oxytocin (OR 0.1; 95% CI: 0.02 – 0.4); fetal weight (OR 1.003; 95% CI: 1.001 – 1.004); interval of cesarean section (OR 0.9; 95% CI: 0.92 - 0.99) and history of vaginal delivery (OR 4.5; 95% CI: 1.03 - 20.08). Conclusion: Pregnant women with once previous cesarean section can follow up vaginal delivery if eligible. Vaginal birth after cesarean section should be performed by an experienced specialist and a medical facility with good resuscitation facilities and conditions.