OBJECTIVE:To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). METHODS:From January 2005 to December 2015, clinical data of 507 cases with VBAC in West China Second Hospital were studied retrospectively. There were 370 cases of VBAC from January 2013 to December 2015 as study group (VBAC group), in contrast, 740 cases of elective repeat cesarean section (ERCS group) and 740 primiparas of vaginal delivery without history of cesarean section as control groups, the pregnancy outcome were analyzed between the study group and control groups respectively. RESULTS:(1) There were 76 547 total births from January 2005 to December 2015. Among these, 10 178 (13.296%, 10 178/76 547) patients had a single prior low transverse cesarean section, of which 4.981% (507/10 178) had VBAC. The incidence of VBAC was rising from 1.020%-3.704% during 2005-2012 to 6.028%-7.662% during 2013-2015. The rate of scared uterus during 2013-2015 was 18.269% (5 539/30 319), of which 9.26% (513/5 539) chose trial of labor after cesarean section (TOLAC). Successful VBAC occurred in 72.12% (370/513) of patients with TOLAC, and 27.88% (143/513) delivered by emergency cesarean. (2) The following parameters of the successful group and the unsuccessful VBAC group were compared, maternal age (29±4) versus (34±4) years, body mass index at prenatal visit (22.2±1.4) versus (22.6±1.4) kg/m(2), gestational age (38.7±0.9) versus (39.6±1.3) weeks, birth weight (3 326±317) versus (3 404±285) g, and the rate of induction of labor 0 (0/370) and 6.29% (9/143), there were significant differences (all P<0.01). There was no statistical difference between two group for lower uterine segment (P=0.947). (3) The duration of labor of VBAC group and 740 primiparas of vaginal delivery without history of cesarean section was compared, (10.3±1.8) versus (11.5±2.0) hours, there was significant difference (P<0.01). There were no statistical difference between two groups for the following parameters, including postpartum hemorrhage, hospitalization duration, the ratio of 5-minute Apgar score≥8, neonatal admission rate (all P>0.05). (4) The postpartum hemorrhage and hospitalization duration in VBAC group incidence were respectively (194±34) ml and (2.32±0.49) days, and the indexes of the ERCS group were respectively (419±57) ml and (4.14±0.78) days, there were significant differences (all P<0.01). There were no statistical difference between two groups for the ratio of 5-minute Apgar score≥8 and neonatal admission rate (all P>0.05). CONCLUSIONS:The majority of patients choose ERCS rather than TOLAC. It's important to assess the indications and contraindications of patients for the successful VBAC, and to monitor maternal and fetal conditions during the delivery process. The premise of TOLAC is a comprehensive understanding of closely monitoring the progress of delivery. Compared with the ERCS, VBAC could reduce patients' postpartum hemorrhage and hospitalization duration, improve the outcomes of pregnancy, and the cesarean section rate could be reduced.
Advanced Materials Science and Technology is a peer-reviewed open access journal published semi-annual online by Omniscient Pte. Ltd. The journal covers the properties, applications and synthesis of new materials related to energy, environment, physics, chemistry, engineering, biology and medicine, including ceramics, polymers, biological, medical and composite materials and so on.
目的 分析中药联合微波治疗妇产科腹部手术切口脂肪液化患者的效果.方法 选取2020年10月—2021年10月妇产科腹部手术切口脂肪液化患者80例,随机分为常规组(常规治疗)和实验组(中药联合微波治疗),每组均为40例,对比两组患者治疗效果、切口愈合时间、住院时间以及切口裂开率.结果 实验组患者治疗效果优于常规组(P<0.05),实验组患者切口愈合耗时、住院治疗耗时、切口裂开率及并发症发生率低于常规组(P<0.05).结论 采用中药联合微波治疗妇产科腹部手术切口脂肪液化患者,可以减少患者住院时间及切口裂开率
目的 探究强化风险护理联合行为干预对新生儿黄疸蓝光照射的安全性影响.方法 选取2022年4月—2023年4月接收的黄疸新生儿94例,均实施蓝光照射,按照系统分配法划分为两组,每组各47例.对照组应用行为护理,观察组应用强化风险护理联合行为干预,对比两组患儿的护理效果.结果 观察组患儿家属的护理满意度显著高于对照组(P<0.05),观察组患儿的临床指标显著优于对照组(P<0.05),观察组患儿的不良反应发生率显著低于对照组(P<0.05).结论 强化风险护理联合行为干预在新生儿黄疸护理中的效果较好,可以提升
目的 分析急诊护理干预对心肺复苏后患者康复效果的影响.方法 选取2021年11月—2023年9月心肺复苏患者60例,随机分为对照组和研究组,每组均为30例.对照组患者实施常规护理,研究组患者实施急诊护理,对比两组患者的康复效果、心理状态及生活质量.结果 研究组患者有效率高于对照组(P<0.05);护理后,两组患者心理状态评分低于护理前(P<0.05);研究组患者心理状态评分低于对照组(P<0.05);两组患者生活质量评分高于护理前(P<0.05),研究组患者生活质量评分均高于对照组(P<0.05).结论
