A total of 5 154 women delivered in Luopu County People Hospital, Hetian Prefecture, Xinjiang Uyghur Autonomous Region from January 2011 to December 2012. Among them, 178 Uyghur women had
cesarean section history. The interval between the previous
cesarean section and this delivery varied from 1 year to 17 years. The number of cases attempting vaginal labor and the indications of the previous
cesarean section were recorded. The indications for the second
cesarean section were analyzed. The gestational weeks at delivery, blood loss in 2 hours after delivery, neonatal
birth weight, newborn
asphyxia, the rate of postpartum
fever (≥ 38 °C) and hospitalization days were compared between the two approaches of delivery.
RESULTS: (1) Among the 178 cases, 119 cases attempted vaginal labor, the rate of attempting vaginal labor was 66.9% (119/178). A total of 113 cases succeeded in vaginal delivery (the vaginal delivery group), with the successful rate of attempting vaginal delivery of 95.0% (113/119), and the successful rate of vaginal delivery was 63.5% (113/178). For those 119 women succeeded in vaginal delivery, the indications of the previous
cesarean sections were as following:
pregnancy complications (68.1%, 81/119), macrosomia(5.0%, 6/119),
dystocia (14.3%, 17/119), pregnancies complicated with other diseases (5.0%, 6/119) and
cesarean section on maternal request (7.6%, 9/119). (2) 15 cases in the
cesarean section group had
postpartum hemorrhage, with the incidence of 13.3% (15/113). The mean total labor time was (507 ± 182) minutes. 6 cases attempting vaginal delivery failed and turned to
cesarean section. (3) 59 cases received the second
cesarean section (the
cesarean section group). The rate of second
cesarean section was 33.1% (59/178). The indications of the second
cesarean section were as following: contracted pelvis (5%, 3/59),
pregnancy complications (42%, 25/59), macrosomia (20%, 12/59), short interval between the two
cesarean sections (≤ 2 years); (12%, 7/59) and
cesarean section on maternal request (20%, 12/59). (4) Gestational weeks at delivery, rates of newborn
asphyxia in the vaginal delivery and
cesarean section groups showed no significant statistical difference (P > 0.05). In the vaginal delivery group, the average blood loss in 2 hours after delivery was (259 ± 213) ml, the rate of postpartum
fever was 10.6%, the mean fetal
birth weight was (3 272 ± 477)g and the mean hospitalization was (1.8 ± 1.6) d. In the
cesarean section group, they were (400 ± 320) ml, 54.2%, (3 539 ± 500)g and (8.7 ± 2.2)d, respectively. There was significant statistical difference (P < 0.01) between the two groups.
CONCLUSIONS: