Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s s...Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25 - 29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25 - 29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.展开更多
Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recover...Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.展开更多
Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most o...Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most of obstetricians to increase the num ber of cesarean sections following a previous cesarean section. Guidelines for Vaginal birth after cesarean (VBAC) indicate that TOLAC offers women with no contraindications and one previous transverse low-segment cesarean. The objective of the current study was to study the outcome of trial of labour after caesarean section (TOLAC), the indications for emergency repeat cesarean section and to determine the maternal and fetal prognosis in vaginal birth after caesarian section (VBAC) at Tshikaji Mission Hospital. Patients, Material and Methods: This is a retrospective study of the records of 126 women were selected to undergo the TOLAC in the department of gynecology and obstetrics at the Tshikaji Mission Hospital over the period from January 1<sup>st</sup> to December 31<sup>st</sup>, 2021. The data on demography, antenatal care, labour and delivery and outcomes were collected from the maternity unit of this hospital. The data were analyzed using SPSS version 2.0. Results: The TOLAC in 126 studied women. The course of work allowed vaginal delivery 107 parturient women, a success rate of successful VBAC of 85% after the TOLAC. The repeat emergency cesarean section was necessary for delivery in 15% of cases for failed TOLAC. There was no maternal mortality, but we recorded one fetal death or 0.8% of perinatal mortality, 2 cases of cicatricial dehiscence, the incidence of 1.6%. Maternal morbidity after delivery on cicatricial uterus was dominated by postpartum hemorrhages, with 19 cases or 15.1% of cases. Cervical dilatation of more than 3 cm at the time of admission, the parity more than 3 and were the significant factors in favor of a successful VBAC. Birth weight of more than 3500 g, fetal distress and malpresentation were associated with a lower success rate of VBAC. The TOLAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. Conclusion: Pregnancy on a cicatricial uterus represents a high-risk pregnancy. Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. There is a significantly high vaginal birth after caesarian section (VBAC) success rate among selected women undergoing trial of scar in Tshikaji Hospital. TOLAC remains the option for childbirth in low resource settings as Kasai region in DRC. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remain the cornerstone to achieving high VBAC success rate.展开更多
目的探究不同剂量缩宫素(oxytocin,OT)对剖宫产术后再次妊娠经阴道试产(trial of labor after cesareansection,TOLAC)孕妇产程进展、凝血功能和母婴结局的影响。方法回顾性分析138例TOLAC孕妇临床病历资料,根据产程中OT总用量分为低剂...目的探究不同剂量缩宫素(oxytocin,OT)对剖宫产术后再次妊娠经阴道试产(trial of labor after cesareansection,TOLAC)孕妇产程进展、凝血功能和母婴结局的影响。方法回顾性分析138例TOLAC孕妇临床病历资料,根据产程中OT总用量分为低剂量组61例、中剂量组45例和高剂量组32例,比较三组的产程进展、凝血功能、分娩方式、妊娠结局及围产儿结局。结果三组第一产程、第二产程、第三产程及总产程比较,差异均无统计学意义(P>0.05);与用药前比,三组用药后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均降低,纤维蛋白原(FIB)水平均升高,差异有统计学意义(P<0.05),三组间用药后PT、APTT、FIB比较差异无统计学意义(P>0.05)。低剂量组及中剂量组孕产妇的胎盘早剥、新生儿高胆红素血症发生率均低于高剂量组,差异有统计学意义(P<0.05)。结论OT可增强TOLAC孕妇子宫收缩力,改善凝血功能,但大剂量OT可能增加胎盘早剥及新生儿高胆红素血症发生风险。展开更多
文摘Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25 - 29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25 - 29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.
文摘Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.
文摘Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most of obstetricians to increase the num ber of cesarean sections following a previous cesarean section. Guidelines for Vaginal birth after cesarean (VBAC) indicate that TOLAC offers women with no contraindications and one previous transverse low-segment cesarean. The objective of the current study was to study the outcome of trial of labour after caesarean section (TOLAC), the indications for emergency repeat cesarean section and to determine the maternal and fetal prognosis in vaginal birth after caesarian section (VBAC) at Tshikaji Mission Hospital. Patients, Material and Methods: This is a retrospective study of the records of 126 women were selected to undergo the TOLAC in the department of gynecology and obstetrics at the Tshikaji Mission Hospital over the period from January 1<sup>st</sup> to December 31<sup>st</sup>, 2021. The data on demography, antenatal care, labour and delivery and outcomes were collected from the maternity unit of this hospital. The data were analyzed using SPSS version 2.0. Results: The TOLAC in 126 studied women. The course of work allowed vaginal delivery 107 parturient women, a success rate of successful VBAC of 85% after the TOLAC. The repeat emergency cesarean section was necessary for delivery in 15% of cases for failed TOLAC. There was no maternal mortality, but we recorded one fetal death or 0.8% of perinatal mortality, 2 cases of cicatricial dehiscence, the incidence of 1.6%. Maternal morbidity after delivery on cicatricial uterus was dominated by postpartum hemorrhages, with 19 cases or 15.1% of cases. Cervical dilatation of more than 3 cm at the time of admission, the parity more than 3 and were the significant factors in favor of a successful VBAC. Birth weight of more than 3500 g, fetal distress and malpresentation were associated with a lower success rate of VBAC. The TOLAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. Conclusion: Pregnancy on a cicatricial uterus represents a high-risk pregnancy. Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. There is a significantly high vaginal birth after caesarian section (VBAC) success rate among selected women undergoing trial of scar in Tshikaji Hospital. TOLAC remains the option for childbirth in low resource settings as Kasai region in DRC. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remain the cornerstone to achieving high VBAC success rate.
文摘目的探究不同剂量缩宫素(oxytocin,OT)对剖宫产术后再次妊娠经阴道试产(trial of labor after cesareansection,TOLAC)孕妇产程进展、凝血功能和母婴结局的影响。方法回顾性分析138例TOLAC孕妇临床病历资料,根据产程中OT总用量分为低剂量组61例、中剂量组45例和高剂量组32例,比较三组的产程进展、凝血功能、分娩方式、妊娠结局及围产儿结局。结果三组第一产程、第二产程、第三产程及总产程比较,差异均无统计学意义(P>0.05);与用药前比,三组用药后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均降低,纤维蛋白原(FIB)水平均升高,差异有统计学意义(P<0.05),三组间用药后PT、APTT、FIB比较差异无统计学意义(P>0.05)。低剂量组及中剂量组孕产妇的胎盘早剥、新生儿高胆红素血症发生率均低于高剂量组,差异有统计学意义(P<0.05)。结论OT可增强TOLAC孕妇子宫收缩力,改善凝血功能,但大剂量OT可能增加胎盘早剥及新生儿高胆红素血症发生风险。
