To investigate the effect of Operative Vaginal Delivery on women with one previous low transverse cesarean.

This a retrospective study. The clinical data of patients underwent a VBAC(vaginal birth after cesarean section, VBAC) were collected who were admitted to Department of Obstetrics of our hospital from January1, 2014 to December 31, 2018. The patients successfully underwent VBAC were included in the vaginal delivery group, patients who underwent forceps-assisted delivery or vacuum-assisted delivery were included in operative vaginal delivery group. The results and complications of the different groups were compared.

(1)567 patients were enrolled. 475 in vaginal delivery group.92 in operative vaginal delivery group, including 59 forceps-assisted vaginal delivery (62.58%), and 33 vacuum-assisted vaginal delivery (37.42%). (2)There were 29 (31.52%) advanced maternal age cases in operative vaginal delivery group and 89 cases (18.74%) in vaginal delivery group. The difference between the two groups was statistically significant (χ²=7.64, P<0.001); The mean hospitalization time of patients in operative vaginal delivery group was 2.80±0.73 d, and that in vaginal delivery group was 2.04±0.24 d, the difference was statistically significant (t=-18.13, P<0.001). (3) The average amount and incidence of postpartum hemorrhage in operative vaginal delivery group was 316.16±483.67 ml and 5.43%, and that in vaginal delivery group was 201.38±144.43 ml and 1.26%, the differences were statistically significant (t=-4.29, P<0.001; χ²=7.05, P=0.008). there were no statistical difference in the incidence of other delivery complications and neonatal complications between the two groups. (4) Analysis between forceps-assisted group and vacuum-assisted group showed that the determine-to-delivery time interval was shorter in forceps-assisted group(10.36±1.75 min vs 12.12±2.36 min, t=-4.09, P<0.001), but the average hospitalization time was longer(2.95±0.71 d vs 2.55±0.71 d, t=2.63, P=0.010). There were no significant difference in other delivery complications and neonatal complications between the two groups.

Operative vaginal delivery may increase the risk of postpartum hemorrhage, but did not increase the risk of neonatal complications. Appropriate way of instrumental-assisted delivery should be selected according to the situation of mother and fetus.