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世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 22-23页

作者： durnwald c.p. Ehrenberg H.M. Mercer B.M. 石磊

This study was undertaken to determi ne the impact of ma-ternal obesity on success of a trial of labor(vaginal birth after cesarean sectionVBAc)after a single low transverse ce-sarean *** charts of women with low transverse cesarean delivery in their first viable pregnancy who underwent a VBAc in their second v iable pregnancy at our urban tertiary care institution were *** body mass index(BMI )was classified as underweight (clinical characteristics and labor outcomes were *** potentially affecting VBAc success were analyzed by univariate *** re gressions were performed to determine the impact of maternal p regravid BMI on VBAc success after controlling for c onfounding *** 510women attempting a trial of labor,337(66%)were successful and 173(34%)failed *** VBAc success was seen in obese(54.6%)but not over-weight (65.5%)women compared with women of normal BMI (70.5%),p =.003and.36,***-derweight women had more VBAc success than women of normalBMI (84.7%vs 70.5%,p =.04).controlling for other factors,the association b etween increasing pre-gravid BMI and BMI ≥30kg /m 2 with decreased VBAc success persisted,p =.03and.006,r ***-mal BMI women who became overweight before the second pregnancy had decreased VBAc success compared with those whose BMI remained normal(56.6%vs 74.2%,p =.006).However,overweight women who decreased their BMI to normal before the second pregnancy did not significantly improve VBAc success(64.0%vs 58.4%,p =.67).Increasing pregravid BMI and weigh t gain be-tween pregnancies reduce VBAc succe ss after a single low transverse cesarean delivery.

关键词：剖宫产术阴道分娩横切口剖宫分娩结局三级医疗机构单变量分析混杂因素无显著性差异

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维普期刊数据库

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早产史、宫颈长度与引起的复发早产的关系

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 25-26页

作者： durnwald c.p. Walker H. Lundy J.c. Iams J.D. 杨晓梅 Division of Maternal Fetal Medicine Ohio State University Columbus OH United StatesDr.

This study was undertaken to determine rates of recurrent preterm birth according to number of prior preterm births, 1 versus 2 or more and cervical length by endovaginal ultrasound at 220 to 246 weeks, less than 25 mm versus more than 25 mm. Study design: We retrospectively analyzed data from charts of women with prior spontaneous preterm birth seen in a prematurity prevention clinic from 1998 through 2004. Women with a history of 1 or more spontaneous preterm births (180- 366 weeks) were included. Women with multiple gestations, uterine anomalies, and prior cervical surgery were excluded. Transvaginal sonography was used to evaluate each woman’ s cervical length at 220 to 246 weeks. cerclage, bed rest, tocolysis, and steroids were used when clinically appropriate. primary outcome was gestational age at delivery less than 32 and less than 35 weeks. Data were analyzed according to number of prior preterm births (1 vs ≥ 2) and sonographic cervical length at 220 to 246 weeks (preterm birth was 26.3 weeks. Of the total 188, 118 (62.8% ) women had 1 prior and 70 (37.2% ) had 2 or more preterm births. Thirty-eight (20.2% ) of the women had a cervical length less than 25 mm and 150 (79.8% ) had a cervical length 25 mm or greater. A higher percentage of women with a cervical length less than 25 mm and 2 or more preterm births delivered less than 32 weeks compared with women with 1 prior preterm birth, although this did not reach statistical significance (21.5% vs 12.5% , p = .47). Rates of delivery less than 35 weeks in women with a cervical length less than 25 mm were similar in those with a history of 1 and 2 or more preterm births. Women who had 2 or more prior preterm births were analyzed separately to identify if a cervical length greater than 30 mm or greater than 35 mm could be reassuring for decreasing the risk of recurrent preterm birth. conclusion: Rates

关键词：宫颈长度早产率复发经阴道超声测量临床预防纳入标准回顾性分析宫颈环扎术多胎妊娠子宫畸形

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