Analysis of high risk factors for complications in the trial of vaginal delivery due to uterine scarring in a subsequent pregnancy to a cesarean section.

Abstract

The purpose of this work was to analyze the high-risk factors of com-plications in the trial of vaginal delivery of a subsequent pregnancy for scar uterus after a previous cesarean. 136 pregnant women with scar uterus with a history of cesarean who were admitted to our obstetrics department from February 2016 to March 2019 were selected and were divided into a successful group and a failed group according to the results of pregnancy and trial of labor vaginal delivery. Gen-eral data of before, during, and after delivery were collected and the high-risk fac-tors for failed vaginal delivery of scar uterine were analyzed by the logistic regression analysis.Among the 136 patients, 108 cases (79.41%) of vaginal trials were success-ful, and 28 cases (20.59%) of vaginal trials faired.The univariate analysis showed that the differences in gravidity, parity and the previous cesarean interval, vaginal birth history, prenatal BMI, uterine contraction, gestational age, infant weight, dila-tation of the cervix, cervical Bishop score, the height of the fetal head, the thickness of the lower uterus, and whether the membranes were prematurely ruptured were statistically significant (P<0.05). Logistic regression analysis showed vaginal birth history, prenatal BMI ≥ 30 kg/m2, parity ≥ 2 times, cesarean interval <2 times, dilatation of cervix ≥ 1 cm, the height of the fetal head ≥ -3, premature rupture of the membrane and the thickness of the lower uterus of 3.0 to 3.9 cm were the high-risk factors of complications in the vaginal trial delivery of pregnancy again for scar uterus (P<0.05). It is feasible for pregnant women with scar uterus to undergo vaginal delivery, but many related factors can affect the failure of trial of labor. It is necessary to pay attention to all aspects of clinical examination and choose applica-tions strictly according to the indications.