Analysis of Maternal and Infant Outcomes and Related Factors of Vaginal Delivery of Second Pregnancy after Cesarean Section

Abstract

Objective. To explore the clinical effect of different delivery methods and the safety of vaginal delivery of second pregnancy after cesarean section and analyze the related factors. Methods. A total of 738 eligible pregnant women who underwent cesarean section from September 2018 to August 2020 were randomly selected from our hospital. Among them, 527 pregnant women successfully delivered vaginally were selected as the observation group, and 211 pregnant women who failed vaginal delivery were selected as the control group. To analyze the factors that influence the success of vaginal delivery of second pregnancy after cesarean section and compare the outcomes of mother and infant in two groups. Results. There was no significant difference in age, prenatal body mass index (BMI), and thickness of lower uterine segment between the two groups ( $P>0.05$ ). There were significant differences in fetal head orientation, fetal abdominal circumference, fetal biparietal diameter, uterine height, premature rupture of membranes, Bishop score, and epidural anesthesia during labor between the two groups ( $P<0.05$ ). Multivariate logistic regression analysis showed that fetal abdominal circumference, fetal head orientation, Bishop score, and epidural anesthesia during labor were independent factors affecting the success of VBAC ( $P<0.05$ ). There was no significant difference in the incidence of uterine rupture between the two groups ( $P>0.05$ ). The amount of postpartum hemorrhage in the observation group was significantly lower than that in the control group ( $P<0.05$ ). There was no significant difference in Apgar score, asphyxia rate, and hospitalization rate between the two groups ( $P>0.05$ ). There was no significant difference in the incidence of complications between the two groups ( $P>0.05$ ). Conclusion. There are many factors that influence the success of vaginal delivery after cesarean section. Through prenatal comprehensive evaluation of vaginal delivery conditions, we can guide the parturient to choose a reasonable mode of delivery, reduce the incidence of complications, and improve the outcome of mother and baby.