Objective To investigate the clinical outcomes of caesarean section delivery and vaginal delivery in women with scarred uterus repregnancy.

Method  A total of 110 women with scarred uterus repregnancy were retrospectively selected for inclusion in the study, and 55 cases were divided into PGC (cesarean section) group and YDC (vaginal delivery) group according to the different modes of re-pregnancy and delivery. The success rate of maternal delivery in the YDC group was statistically calculated, serum stress stimulatory response indexes (Cor, Ang-II., NE) and inflammatory response index (CRP, TNF-α, IL-6) were detected before and after delivery, and maternal and infant outcomes were compared.

Result  A total of 52 of the 55 women in the YDC group had successful delivery, and the success rate was 94.55% (52/55). At 24 h postpartum, serum Cor, Ang-II. and NE in the YDC group were lower than those in the PGC group. At 24 h and 48 h postpartum, the serum CRP, TNF-α and IL-6 of the YDC group were lower than those in the PGC group. The maternal blood losses during delivery and 24 hours after delivery in the YDC group were lower than those in the PGC group, and the neonatal Apgar score was higher than that in the PGC group, and a total of 7.27% (4/55) of the women in the YDC group had postpartum complications, which was significantly lower than that of 21.82% (12/55) (P<0.05) in the PGC group.

Conclusion  Compared with cesarean section, vaginal delivery in women with scarred uterus repregnancy can effectively reduce the body's stress stimulation response and inflammatory response, and obtain better delivery outcomes. Clinically, it is recommended to select vaginal delivery on the basis of scientific evaluation of the conditions for vaginal trial labor.

1.汪莹, 耿会欣, 艾志刚. 不同手术方式治疗瘢痕子宫切口妊娠的疗效及安全性[J]. 中国妇产科临床杂志, 2021, 22(3): 301-302. [Wang Y, Geng HX, Ai ZG. Efficacy and safety of different surgical methods in the treatment of pregnancy with cicatricial uterine incision[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2021, 22(3): 301-302.] DOI: 10.13390/j.issn.1672-1861.2021.03.030.

2.马新刚, 于迎春, 孟颜颜, 等. 利用有限元分析预警经阴道分娩瘢痕子宫破裂风险[J]. 医用生物力学, 2021, 36(1): 92-95. [Ma XG, Yu YC, Meng YY, et al. Rupture warning of scar uterus in vaginal delivery by finite element analysis[J]. Journal of Medical Biomechanics, 2021, 36(1): 92-95.] DOI: 10.16156/j.1004-7220.2021.01.015.

3.屈在卿, 马润玫, 胡晏馨. 剖宫产后再次妊娠阴道分娩意愿的影响因素探讨[J]. 现代妇产科进展, 2021, 30(1): 37-38, 41. [Qu ZQ, Ma RM, Hu YX. Discussion on the influencing factors of vaginal delivery intention of second pregnancy after cesarean section[J]. Progress in Obstetrics and Gynecology, 2021, 30(1): 37-38, 41.] DOI: 10.13283/j.cnki.xdfckjz.2021.01.006.

4.张秋实, 朱桐梅. 瘢痕子宫阴道试产对母婴分娩结局影响的Meta分析[J]. 护理研究, 2019, 33(19): 3296-3301. [Zhang QS, Zhu TM. Effect of trial of labor after previous cesarean delivery on maternal and neonatal outcomes:a meta-analysis[J]. Chinese Nursing Research, 2019, 33(19): 3296-3301.] DOI: 10.12102/j.issn.1009-6493.2019.19.023.

5.罗香平, 高钰琳. 瘢痕子宫阴道分娩产妇行会阴侧切术后结局分析[J]. 实用医学杂志, 2019, 35(15): 2491-2494. [Luo XP, Gao YL. Outcome analysis of episiotomy in vaginal birth after cesarean puerpera[J]. The Journal of Practical Medicine, 2019, 35(15): 2491-2494.] DOI: 10.3969/j.issn.1006-5725.2019.15.030.

6.谭廷廷, 孙秋蕾, 罗莉, 等. 剖宫产瘢痕妊娠患者经子宫动脉栓塞化疗联合清宫术治疗后再妊娠临床分析[J]. 第三军医大学学报, 2019, 41(17): 1672-1676. [Tan TT, Sun QL, Luo L, et al. Reproductive outcomes of women with cesarean scar pregnancy after uterine artery chemoembolization combined with evacuation[J]. Journal of Third Military Medical University, 2019, 41(17): 1672-1676.] DOI: 10.16016/j.1000-5404.201904016.

7.王林林,杨慧霞,陈俊雅,等. 剖宫产术后子宫瘢痕憩室再次妊娠的不良妊娠结局分析及预测[J]. 中华妇产科杂志, 2022, 57(8): 587-593. [Wang LL, Yang HX, Chen JY, et al. Prediction and analysis of adverse pregnancy outcomes in pregnant women with cesarean scar diverticulum[J]. Chinese Journal of Obstetrics and Gynecology, 2022, 57(8): 587-593.] DOI: 10.3760/cma.j.cn112141-20220107-00011.

8.武玉萍,郑秀丽,刘静芳,等.瘢痕子宫再次妊娠阴道试产结局分析[J]. 现代妇产科进展, 2022, 31(3): 205-207. [Wu YP, Zheng XL, Liu JF, et al. Analysis on the outcome of vaginal trial labor of cicatricial uterus repregnancy[J]. Progress in Obstetrics and Gynecology, 2022, 31(3): 205-207.] DOI: 10.13283/j.cnki.xdfckjz. 2022.03.009.

9.陈晓明, 陈震宇, 孙静莉, 等. 剖宫产术后再次妊娠经阴道分娩预测模型的建立及验证[J]. 现代妇产科进展, 2021, 30(8): 601-605. [Chen XM, Chen ZY, Sun JL, et al. Establishment and verification of prediction model of vaginal delivery after cesarean section[J]. Progress in Obstetrics and Gynecology, 2021, 30(8): 601-605.] DOI: 10.13283/j.cnki.xdfckjz.2021.08.037.

10.倪晓田. 剖宫产后再次妊娠分娩方式选择[J].现代妇产科进展, 2019, 28(10): 798, 800. [Ni XT. Selection of delivery mode of second pregnancy after cesarean section[J]. Progress in Obstetrics and Gynecology, 2019, 28(10): 798, 800.] DOI: 10.13283/j.cnki.xdfckjz.2019. 10.014.

11.王超, 姚颖, 李蓉, 等. 剖宫产瘢痕妊娠的流行病学研究: 现状与展望[J]. 中国妇产科临床杂志, 2021, 22(4): 444-445. [Wang C, Yao Y, Li R, et al. Study on the epidemiology of cicatricial pregnancy in cesarean section: Current situation and prospect[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2021, 22(4): 444-445.] DOI: 10.13390/j.issn.1672-1861.2021.04.037.

12.唐锦清, 桂华, 施艳, 等. 经阴道分娩方式对疤痕子宫再次妊娠产妇免疫及应激效果的影响[J]. 贵州医科大学学报, 2022, 47(7): 826-830. [Tang JQ, Gui H, Shi Y, et al. Effect of vaginal delivery on immune and stress responses of re-pregnant women with scarred uterus[J]. Journal of Guizhou Medical University, 2022, 47(7): 826-830.] DOI: 10.19367/j.cnki.2096-8388.2022.07.014.

13.张丽伟. 不同分娩方式对瘢痕子宫再次妊娠孕妇产后应激状态及母婴结局的影响[J]. 河南医学研究, 2021, 30(7): 1224-1226. [Zhang LW. Effects of different delivery methods on postpartum stress state and maternal and infant outcomes of pregnant women with second pregnancy with scar uterus[J]. Henan Medical Research, 2021, 30(7): 1224-1226.] DOI: 10.3969/j.issn.1004-437X.2021.07.023.

14.张奕君, 徐金凤. 不同分娩方式对瘢痕子宫再次妊娠患者及新生儿的影响[J]. 河南医学研究, 2022, 31(14): 2590-2593. [Zhang YJ, Xu JF. Influence of different delivery methods in patients with scarred uterus re-pregnancy and neonatus[J]. Henan Medical Research, 2022, 31(14): 2590-2593.] DOI: 10.3969/j.issn.1004-437X.2022.14.024.

15.朱进璐, 许张晔. 剖宫产子宫瘢痕缺损程度与再妊娠分娩方式及母婴结局的相关性[J]. 中国妇幼保健, 2021, 36(6): 1229-1231. [Zhu JL, Xu ZY. The relationship between the degree of uterine scar defect in cesarean section and the mode of delivery and maternal and infant outcomes[J]. Maternal & Child Health Care of China, 2021, 36(6): 1229-1231.] DOI: 10.19829/j.zgfybj.issn.1001-4411.2021.06.004.