Neonatal outcomes of patients with vaginal delivery after a Caesarean section

Yıl 2023, Cilt: 48 Sayı: 4, 1357 - 1364, 29.12.2023

Emre Uysal Nur Gözde Kulhan Oğuzhan Günenc

https://doi.org/10.17826/cumj.1369430

Öz

Purpose: The rates of caesarean section (CS) have been increasing in recent years in Türkiye and throughout the world. A previous CS is known to not be an absolute indication for repeat CS, and vaginal delivery (VD) (trial of labor after caesarean (TOLAC)) can occur after a CS. The aim of this study was to investigate the neonatal outcomes of TOLAC patients in Konya City Hospital.
Materials and Methods: A retrospective analysis was made of the records of all the births in Konya City Hospital between 10 August 2020 and 10 June 2022. The study included all patients with full or nearly complete cervical dilation-effacement and who had a previous CS. These patients were compared with patients who had elective CS and VD. A total of 119 patients were included in the study in 3 groups; TOLAC n:32, CS n:42, VD n:45.
Results: TOLAC patients gave birth earlier and the infant birth weight (2991.25gr), length (50.66cm) and head circumference (34.09cm) measurements were found to be significantly lower than those of the other groups. The development of any problem (icterus, respiratory distress syndrome (RDS), oxygen requirement, hypoglycemia, hypothermia) was determined at a significantly higher rate in the TOLAC (21.9%).
Conclusion: Patients with a history of CS do not have to have a repeat CS. TOLAC can be performed in appropriate cases, but care should be taken against uterine rupture, the need for emergency CS, and adverse neonatal outcomes.

Anahtar Kelimeler

caesarean section, neonatal, neonatal outcomes, trial of labor after caesarean

Etik Beyan

Approval for this study was obtained from the Local Ethics Committee (decision numbered 9.30.2022 - 22/425)

Destekleyen Kurum

None

Teşekkür

Thanks to Caroline Jane WALKER for her help with English Grammar

Sezaryen sonrası vajinal doğum yapan hastaların yenidoğan sonuçları

Öz

Amaç: Son yıllarda Türkiye'de ve dünyada, sezaryen (CS) oranları giderek artmaktadır. Önceki sezaryenlerın tekrar sezaryen için mutlak bir endikasyon olmadığı bilinmektedir ve sezaryen sonrası vajinal doğum (trial of labor after caesarean (TOLAC)) gerçekleşebilmektedir. BU çalışmanın amacı Konya Şehir Hastanesi'ndeki TOLAC hastalarının neonatal sonuçlarını araştırmaktır..
Gereç ve Yöntem: 10 Ağustos 2020 ile 10 Haziran 2022 tarihleri arasında Konya Şehir Hastanesi'nde gerçekleşen tüm doğumların kayıtlarının retrospektif analizi yapıldı. Çalışmaya tam veya tama yakın servikal dilatasyon-efasması olan ve daha önce sezaryen öyküsü olan tüm hastalar dahil edildi. Bu hastalar elektif CS ve vajinal doğum (VD) geçiren hastalarla karşılaştırıldı. Çalışmaya 3 grupta toplam 119 hasta dahil edildi; TOLAC n:32, CS n:42, VD n:45.
Bulgular: TOLAC hastalarının daha erken doğum yaptığı görüldü ve bebek doğum ağırlığı (2991.25gr), boyu (50.66cm) ve baş çevresi (34.09cm) ölçümlerinin diğer gruplara göre anlamlı derecede düşük olduğu görüldü. TOLAC'ta herhangi bir yenidoğan probleminin (sarılık, solunum sıkıntısı sendromu (RDS), oksijen ihtiyacı, hipoglisemi, hipotermi) gelişimi anlamlı olarak daha yüksek oranda bulundu (%21,9).
Sonuç: Sezaryen öyküsü olan hastaların tekrar sezaryen geçirmesine gerek yoktur. TOLAC uygun vakalarda yapılabilir ancak uterus rüptürü, acil sezaryen ihtiyacı ve olumsuz neonatal sonuçlara karşı dikkatli olunmalıdır.

Anahtar Kelimeler

Sezaryen, yenidoğan, yenidoğan sonuçları, sezaryen sonrası vajinal doğum (TOLAC), vajinal doğum

Kaynakça

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