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自1981年起,美国的剖宫产率明显增加,是前次剖宫产史占1/3的指征。作者集中5年间11所医学中心有前次剖宫产史后阴道分娩的资料,其中包括有1次以上剖宫产史者。本文除外已知前次为古典式或下段纵切口、臀先露和双胎者。分娩时行电子胎心率(FHR)及子宫活动连续监护。有指征时应用硬膜外麻醉和催产素加强产力。规定子宫破裂为有症状的或需手术处理的全子宫壁缺损。1984～1988年分娩163814次,前次剖宫产者15098(9.2%)次,其中5733例(38.0%)试产,4291(74.8%)例阴道分娩成功。1984～1985年9所医学中心前次剖宫产4929例,试产1776例(36%),阴道分娩成功1 314例(74%)。1986～1988年11所医学中心前次剖宫产10169例,试产3957例(39%),
Since 1981, there has been a marked increase in cesarean section rates in the United States, an indication of one-third of the previous cesarean section. The authors concentrated in the past five years, 11 medical centers have the history of vaginal delivery after cesarean section information, including more than one history of cesarean section. This article except for the previous known as the classical or lower longitudinal incision, buttocks exposed and twins. Childbirth electronic fetal heart rate (FHR) and continuous monitoring of uterine activity. Apply epidural anesthesia and oxytocin to boost productivity when indicated. Prescribed uterine rupture as a symptomatic or surgical treatment of the entire uterine wall defect. Between 1984 and 1988, 163,814 deliveries were performed, and 15,898 (9.2%) of the previous cesarean sections were delivered. Of these, 5733 (38.0%) were piloted and 4291 (74.8%) were successfully delivered vaginally. From 1984 to 1985, 4929 cesarean sections were conducted in 9 medical centers, with 1776 cases (36%) being piloted and 1 314 (74%) successful in vaginal delivery. From 1986 to 1988, there were 10,169 cesarean sections in 11 medical centers, 3957 trial-produced cases (39%),