关键词: 剖宫产后阴道分娩, 分娩, 产道, 妊娠结局

Abstract: Objective　To investigate the labor time in vaginal birth after cesarean section（VBAC） so as to get definite evaluating and monitoring points of VBAC.Methods　75 pregnant women who underwent trial of labor after cesarean（TOLAC） in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2012 to June 2015 were selected.Among them,70 cases（VBAC,93.3%） had successful vaginal delivery,5 cases（6.7%） with unsuccessful vaginal trial production underwent cesarean section again.According to the timing of previous cesarean section,70 pregnant women with VBAC were divided into cesarean section after vaginal trial of production group（n=23） and elective cesarean section group（n=47）,and their stages of labor were recorded.Results　The average age and parity of patients in elective cesarean section group were respectively younger and less than those of patients in cesarean section after vaginal trial of production group（P<0.05）;the comparison of gestational age,times of pregnancy,pre-pregnancy BMI,prenatal BMI,thickness of lower uterine segment and premature rupture of membrane through ultrasonic testing,and proportion of gestational diabetes and pregnancy complicated with hypertension among pregnant women in two groups was not significantly different（P>0.05）.There was no significant difference in times of the first stage of labor,the second stage of labor and total stage of labor among pregnant women with no history of vaginal delivery in two groups（P>0.05）;there was no significant difference in times of the first stage of labor,the second stage of labor and total stage of labor among term delivery women with no history of vaginal delivery in two groups（P>0.05）.The amount of postpartum hemorrhage,neonatal weight,neonatal Apgar score,and the proportion of puerperal infection,fetal distress,amniotic fluid Ⅲ,neonatal morbidity,forceps delivery and maternal postpartum hemorrhage among pregnant women in two groups were not significantly different（P>0.05）.Conclusion　There is no effect of VBAC pregnant women with or without trial production in previous delivery on labor time and pregnancy outcome,the persistent progress of labor time is key to the successful vaginal delivery.Risks should be fully evaluated again for patients with labor stagnation or related manifestations,so as to reduce the risk of uterine rupture after cesarean section.

Key words: Vaginal birth after cesarean, Labor,obstetric, Pregnancy outcome