Abstract：Objective To explore the factors influencing the delivery mode of re-pregnant women with scar uterus and analyze the pregnancy outcome. Methods A retrospective analysis of 423 cases of re-pregnant women with scar uterus was conducted.According to the success of vaginal trial delivery,they were divided into vaginal delivery group and cesarean section group.Logistic regression model was used to analyze the related factors affecting delivery mode,and the pregnancy outcomes of vaginal delivery group and cesarean section group were observed. Results Among 423 re-pregnant women with scar uterus,203 cases met the vaginal trial delivery standard and voluntarily performed vaginal trial delivery,the vaginal trial delivery rate was 47.99%（203/423）,the success rate of vaginal delivery was 40.90%（173/423）,and the cesarean section rate was 59.10%（250/423）;Logistic regression analysis results showed that：prenatal BMI>30kg/m2（OR=1.951,95% CI=1.169-3.254）,time from last cesarean section ≤3 years（OR=2.664,95% CI=1.539-4.611）,thickness of uterine scar ≤4mm（OR=3.322,95% CI=1.971-5.599）,cervical Bishop score ≤3（OR=2.682,95% CI=1.580-4.552）,neonatal weight>35000g（OR=2.579,95% CI=1.322-5.95% CI=1.971-5.599）were independent risk factors of vaginal delivery in re-pregnant women with scarred uterus（P<0.05）;the amount of postpartum hemorrhage and hospitalization time in vaginal delivery group were less than those in cesarean section group（P<0.05）,and puerperal infection rate was lower than that in cesarean section group（P<0.05）;there was no significant difference in fetal distress rate,postpartum hemorrhage rate,neonatal asphyxia rate and Apgar score at 1 min after birth between the two groups（P>0.05）. Conclusion Prenatal BMI,time from last cesarean section,thickness of uterine scar,cervical Bishop score and neonatal weight are independent influencing factors of delivery mode of re-pregnant women with scar uterus.Compared with cesarean section,vaginal delivery can effectively reduce postpartum hemorrhage,reduce puerperal infection rate,and will not increase the incidence of fetal distress and neonatal asphyxia.
2022, Vol. 42 
