剖宫产后阴道分娩的现况

Analysis on Current Situation of Vaginal Birth After Cesarean Section

剖宫产后阴道分娩(vaginal birth after cesarean section,VBAC)是指既往有剖宫产史者,再次妊娠时采用阴道分娩的方式。因对VBAC安全性的疑虑,以往绝大部分产妇以再次剖宫产终止妊娠,但经临床实践和研究证实,VBAC的主要影响因素有剖宫产切口类型及缝合方式、剖宫产次数、既往有无阴道分娩、孕产妇年龄及体质量、胎儿体质量及是否多胎妊娠和本次阴道试产是否采用缩宫素及前列腺素E2引产。只要严格把握VBAC的指征,认真评估VBAC的母婴风险,严密监护和及时处理异常情况,VBAC是安全、有效、经济的分娩方式。正确应用VBAC,可提高其安全性和成功率,进而降低异常升高的剖宫率。

Vaginal birth after cesarean section（VBAC）refers to pregnant women with a history of cesarean section select vaginal delivery to terminate the pregnancy.For a long time,the safety of VBAC is doubted,so most of the pregnant women select repeat cesarean section to terminate the pregnancy.However,over half a century of clinical practice and study,it is known that the main factors of VBAC include cesarean section incision type and suture,the number of cesarean section,the history of vaginal delivery or not,maternal age and weight,fetus weight,multiple pregnancies and whether induction of labor with oxytocin and prostaglandin E2 using in this trial of labor.What′s more,it has confirmed that VBAC is a safe,effective and economical mode of delivery,as long as we strictly keep to VBAC indications,carefully assessing the risk of VBAC for mother and fetus,intensively monitoring and timely handling the abnormalities.The proper application of VBAC will greatly enhance the safety and success rate of VBAC,thus it can reduce the abnormal increase of the rate of cesarean section.