Early identification and management of uterine rupture in vaginal birth after cesarean section

doi:10.3877/cma.j.issn.2095-3259.2017.01.003

Abstract

Abstract:

The incidence rate of uterine rupture in vaginal birth after cesarean (VBAC) is low, but uterine rupture in VBAC is a severe complication. Once it occurs, maternal and perinatal adverse outcomes may happen. Standardizing management of VBAC and promoting emergencies processing capacity of obstetrician are helpful to implement VBAC safely and recognize uterine rupture timely. Meanwhile, it will decrease poor prognosis of mother and fetus.

Key words: Vaginal birth after cesarean, Uterine rupture, Cesarean Section, repeat

Hang Li, Runmei Ma. Early identification and management of uterine rupture in vaginal birth after cesarean section[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2017, 06(01): 9-13.

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References 19

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胎监分类	FIGO分级系统	胎心基线	胎监变异或反应性	减速
正常胎监	FIGO 1	110～150 bpm	1.5～25 bpm	1.早期减速
?	?	?	2．增速	2．变异减速(<60 s，减速幅度<60次)
可疑胎监	FIGO 2	1.100～110 bpm	1.>25 bpm	变异减速(<60 s，减速幅度>60次)
?	?	2.150～170 bpm	2．<5 bpm，持续>40 min且无增速	?
?	?	3．短暂胎儿心动过缓(<100 bpm，≤3 min)	?	?
几项"可疑胎监(FIGO 2)"一起出现时可能形成"异常胎监(FIGO 3)"
异常胎监	FIGO 3	1.150～170 bpm，变异减少>170 bpm	1.<5 bpm，持续>60 min	1.变异减速>60 s
?	?	2．持续心动过缓(<100 bpm且持续>3 min)	2．正弦波形	2．反复晚期减速
临终前胎监	FIGO 4	缺乏变异(<2 bpm)及增速，伴或不伴减速或心动过缓

胎监分类	FIGO分级系统	胎心基线	胎监变异或反应性	减速
正常胎监	FIGO 1	110～150 bpm	1.5～25 bpm	1.早期减速
?	?	?	2．增速	2．变异减速(<60 s，减速幅度<60次)
可疑胎监	FIGO 2	1.100～110 bpm	1.>25 bpm	变异减速(<60 s，减速幅度>60次)
?	?	2.150～170 bpm	2．<5 bpm，持续>40 min且无增速	?
?	?	3．短暂胎儿心动过缓(<100 bpm，≤3 min)	?	?
几项"可疑胎监(FIGO 2)"一起出现时可能形成"异常胎监(FIGO 3)"
异常胎监	FIGO 3	1.150～170 bpm，变异减少>170 bpm	1.<5 bpm，持续>60 min	1.变异减速>60 s
?	?	2．持续心动过缓(<100 bpm且持续>3 min)	2．正弦波形	2．反复晚期减速
临终前胎监	FIGO 4	缺乏变异(<2 bpm)及增速，伴或不伴减速或心动过缓

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