Zhonghua fu chan ke za zhi
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Zhonghua Fu Chan Ke Za Zhi · Oct 2016
Comparative Study[The outcome of trial of labor after cesarean section].
Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. ⋯ The isolated risk factors for admission to the NICU were preterm birth(OR=16.71, 95% CI: 11.44-24.40), hypertensive disorder complicating pregnamcy(OR=3.89, 95% CI: 2.39-6.35), meconium stained amniotic fluid(OR=2.48, 95% CI: 1.62-3.80), small for gestational age(OR=2.00, 95% CI: 1.19-3.36)and diabetes mellitus(OR=1.69, 95% CI: 1.14-2.50). Conclusions: VBAC reduces cesarean section rate, with good outcomes in both mother and neonate. It is a safe and feasible way of labor in women with only one cesarean section history.
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Zhonghua Fu Chan Ke Za Zhi · Oct 2016
[Multiposition spiral suture of the lower uterine segment: a new technique to control the intraoperative bleeding of pernicious placenta previa].
Objective: To explore the efficacy and safety of multiposition spiral suture of the lower uterine segment, a new technique to control the intraoperative bleeding of pernicious placenta previa(PPP). Methods: From May 2014 to May 2015, 38 patients were diagnosed PPP in Tongji Hospital and cesarean sections were performed. After removing the placenta, multiposition spiral suture was used when massive bleeding occurred, and bilateral descending branches of uterine artery ligation was conducted when necessary. ⋯ No complication was found in 6 months after the operation. Conclusions: The multiposition spiral suture technique is a simple, safe and effective way to control the massive bleeding in the cesarean section of PPP patients. It is also beneficial for the recovery of the uterus.