• Optimization of clinical approach to women with a history of caesarean section
en To content

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.


REFERENCES

1. Bulanov MN. 2004. Ultrasound diagnosis of cervical pathology: Authorеferat. Dis d.med.n. 14.00.19. M:40.

2. Voskresensij SL. 1993. Ultrasound in childbirth. Ultrasound diagnosis in obstetrics and gynecology 2:110-119.

3. Nazarenko LG, Dubrova LJ, Solovyov N. 2010. About birth after cesarean section: the arguments and facts. Women's Health 7(53):117-121.

4. Chekhonatskaya ML, Yannaeva NE, Grishaeva LA et al. 2012. Changes of venous blood flow in the lower segment and cervix in physiological preliminary period. Saratov Journal of Medical Science 3(8):729-733.

5. Grobman WA, Lai Y, Landon MB et al. 2007. Development of a nomogram for prediction of vaginal birth after cesarean. Obstet&Gynecol. 109:806-812. http://dx.doi.org/10.1097/01.aog.0000259312.36053.02

6. Khatib N, Emad M, Beloosesky R et al. 2015. New model, based on cervical length, predicts successful VBAC. Am J Obstet Gynecol. JAN:S195. http://dx.doi.org/10.1016/j.ajog.2014.10.418

7. Metz TD, Stoddart GJ, Henry E et al. 2013. How do good candidates for trial of labor after cesarean (TOLAC) who undergo elective repeat cesarean differ from those who choose TOLAC? Am J Obstet Gynecol. 208:458.e1-6. http://dx.doi.org/10.1016/j.ajog.2013.02.011; PMid:23395923 PMCid:PMC3742738

8. Palatnik A, Grobman WA. 2015. Induction of labor versus expectant management for women with a prior cesarean delivery. Am J Obstet Gynecol. 212:358.e1-6. http://dx.doi.org/10.1016/j.ajog.2015.01.026http://dx.doi.org/10.1016/j.ajog.2014.10.083

9. Shree R, Caughey AB, Chandrasekaran S. 2016. Can clinical characteristics predict success of operative vaginal delivery? Am J Obstet Gynecol. Jan:S210. http://dx.doi.org/10.1016/j.ajog.2015.10.419

10. Zhang J, Troendle J, Reddy UM et al. 2010. For the Consortium on Safe Labor. Contemporary cesarean delivery practice in the United States. Am J Obstet Gynecol. 203:326.e1-10. http://dx.doi.org/10.1016/j.ajog.2010.06.058; PMid:20708166 PMCid:PMC2947574