摘要
Abstract
Objective:To review the present situation and outcomes of pregnant women with different modes of delivery,which was aim to be a reference for clinic.Method:The first author in the domestic and foreign databases for the study of the mode of delivery after cesarean section in our country were retrieved, in accordance with the inclusion and exclusion criteria for the selection and inclusion of the literature.The language was limited to Chinese and English,the basic information and effective data of the literature was extracted and analyzed.All of the above-mentioned works were done by two reviewers independently and the third party made the choice when summary the different views.Evaluation bias toP<0.1 and the outcomes analysis toP<0.05 for the difference was statistically significant.Result:22 chinese studies of recent decades were included,which had 1301 pregnant women in vaginal birth after cesarean delivery(VBAC) group and 3558 caes in repeat cesarean section(RCS) group.From the analysis,the rate of trail of labor(TOL) wasr=0.35, 95%CI(0.28,0.44),P<0.0001;rate of TOL successful wasr=0.76,95%CI(0.71,0.81),P<0.0001.The level of postpartum hemorrhage was SMD=-6.41,95%CI(-6.88,-5.94),P<0.000 01,hemorrhage in labor was SMD=-3.57,95%CI(-4.69,-2.44),P<0.000 01],time of hospitalization was SMD=-6.86,95%CI(-8.12,-5.59),P<0.000 01 and the rate of puerperal infection wasOR=0.37,95%CI(0.21,0.67),P=0.0009.There was no significant difference of two groups in the incidence of uterine severe complicationOR=0.38,95%CI (0.10,1.50),P=0.17.Conclusion:The rate of trail of labor is low but the rate of successful VBAC from TOL is positive.Pregnant women who choose VBAC may have better outcomes for themselves,but the evidence of getting down the rate of uterus of complications is not powerful enough to show statistically significant difference.Some of the inclusive studies do not have enough high quality as well as the others,which may affect the power of the evaluation results,so more better studies should be done to make the certification.关键词
瘢痕性子宫/妊娠/分娩方式/Meta分析Key words
Scar uterus/Pregnant/Delivery mode/Meta analysis
