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Optimization of clinical approach to women with a history of caesarean section

HEALTH OF WOMAN.2016.7(113):62–65; doi 10.15574/HW.2016.113.62 

Optimization of clinical approach to women with a history of caesarean section

Nazarenko L. G., Nedorezov K. M.

Kharkiv medical Academy of postgraduate education

The CLINICAL Kharkov city clinical maternity hospital № 6

The artikle presents study allowance reducing the frequency of cesarean delivery (CD) by implementing practices vaginal birth in women after caesarean section (VBAC), with improved functional test for status uterine scar.

The objective: to determine the influence of the number VBAC the overall level of the CD, the opportunity to refine prognosis for success VBAC based functional evaluation of the uterus and fetal at full-term pregnancy.

Patients and methods. Was held cohort study material for hospital of 2 lewel of perinatal care for 2008-2015., in terms of introducing VBAC practices, and (2) a investigation of two groups of women for assessing perfusion in cervix and low segment of uterine Doppler influenced by contraction test.

Results. Implementation VBAC institution 2 of perinatal care resulting in lower frequency in 25%. Successful attempt of VBAC have 51.6%, unsuccessful in 9.3% of the women with a uterine scar, elective repeat the CD performed in 39.1%. There is increasing lewel in the percentage of women with a history of the CD in the study cohort – from 4.1% in 2008 to 6.5% in 2014. Posted pathogenetic base for hemodynamic assessment cervics and low segment of uterine areas in contracting test as adequate modern approach to prognosis successful attempt successful attempts for the mother and fetus.

Conclusions. The proposed test can objectively assess the chances of successful attempt VBAC to form arguments to try VBAC or repeat CD.

Key words: cesarean section, uterine cervix, vaginal delivery, prognosos.


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