The choice of delivery modes for the second pregnancy after cesarean section and safety of vaginal delivery

ObjectiveTo explore the choice of delivery mode and safety of vaginal delivery in the second pregnancy after cesarean section.

MethodsEighty women with second pregnancy after cesarean section were studied.Thirty-eight pregnant women with vaginal delivery and 42 pregnant women with cesarean section were divided into the observation group and control group A, respectively.Fifty primiparas in the same period were set as the control group B.The delivery outcome and general clinical situation among three groups were compared.

ResultsThe success rate of trial delivery in observation group was lower than that in control group B, and the vaginal delivery rate in observation group was higher than that in control group B(P < 0.05).The amount of bleeding during delivery and postpartum, length of hospital stay and incidence rate of postoperative complications in observation group were lower than those in control group A(P < 0.05 to P < 0.01).The differences of the postpartum blood loss, length of labor, length of hospital stay and Apgar score between the observation group and control group B were not statistically significant(P>0.05).The differences of the lower uterine thickness and pelvic adhesion among three groups were statistically significant(P < 0.01).After 7-10 years of cesarean section, the lower uterine segment of pregnant women became significantly thin, and the difference of the lower uterine segment between the pregnant woman with cesarean section for 7-10 years and pregnant woman with cesarean section for 2-6 years, control group B were statistically significant(P < 0.01).The lower uterine segment in the control group B became significantly thinner compared with pregnant woman with cesarean section for 2-6 years(P < 0.01).The pelvic adhesion ratios in the pregnant woman with cesarean section for 7-10 and 2-6 years increased compared with the control group B(P < 0.05 to P < 0.01).

ConclusionsCompared with the cesarean section, vaginal delivery for the second pregnancy in pregnant women with cesarean section have obvious advantages in the amount of intraoperative blood loss and postoperative recovery.Therefore, the prenatal monitoring should be strengthened, and the indications and clinical indications of vaginal delivery should be strictly controlled in order to improve the success rate and safety of vaginal delivery.