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DELIVERY AFTER CESAREAN SECTION

Frane Mikulandra
Tomislav Miletić
Eugenio Stoini
Jozo Anić
Mila Periša
Nelka Tomić


Puni tekst: hrvatski pdf 81 Kb

str. 121-124

preuzimanja: 2.825

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Sažetak

Objective. To examine deliveries of pregnant women with a previous cesarean delivery. Methods. Pregnant women were studied according to indications for cesarean section, age, interpregnancy interval, gestational age, trial of labor, delivery completion and perinatal mortality. Deliveries at 23 weeks’ gestation and newborn infants weighing 500 g were analyzed. Statistical analysis was performed using the 2-test with 2×2 contingency tables. The difference was considered to be significant at p<0.05. Results. Among 20766 singleton deliveries between January 1, 1983, and December 31, 2002, 1175 (5.66%) were cesareans. Of those 1175 women with cesarean section, 516 (43.8%) have had a previous cesarean delivery. In actual pregnancy 152 (29.5%) had elective repeat cesarean delivery, and 142 (27.5%) had emergency cesarean delivery. Vaginal delivery was attempted in 364 women: 289 (79.4%) had spontaneous onset of labor, 53 (14.6%) planned delivery, and 22 (6.0%) induced labor. Delivery was completed by cesarean section in 121 (41.9%) of 289 with spontaneous onset of labor, in 6 (11.3%) of 53 with planned delivery, and in 15 (68.2%) of 22 with induced labor (p<0.001) respectively. Uterine rupture was found in two women after delivery, whereas in one woman it was identified during delivery. Complication rates were lowest in women with attempted vaginal delivery (5.8%), then in women with elective repeat cesarean delivery (12.5%), whereas they were highest in women with emergency cesarean delivery (20.4%) (p<0.001). Late fetal death occurred in 1.16%, and early neonatal death in 1.74%, resulting in a 2.91% total perinatal death rate. There was no maternal death. Conclusion. Pregnant women with a previous cesarean delivery should attempt vaginal birth, however, with a liberal obstetrician’s attitude for eventual cesarean delivery.

Ključne riječi

cesarean delivery; delivery after cesarean section; uterine rupture; perinatal mortality

Hrčak ID:

15592

URI

https://hrcak.srce.hr/15592

Datum izdavanja:

1.9.2004.

Podaci na drugim jezicima: hrvatski

Posjeta: 5.286 *