【摘要】 我国剖宫产率一直居高不下，而剖宫产率上升导致瘢痕子宫(scar uterus，SU)增加。随着国家生育政策的开放，剖宫产后再次妊娠分娩方式的选择成为产科医生面临的比较重要的问题，孕产妇可选择剖宫产后阴道试产(trial of labor after cesarean，TOLAC)，或选择性再次剖宫产(elective repeat cesarean section，ERCS)。相对TOLAC，ERCS并发症较多，如子宫二次损伤、瘢痕憩室、子宫瘢痕部位妊娠等，而阴道分娩可以减少这些并发症的发生。但SU阴道分娩成功与否受到很多因素的影响，对既往有SU的孕产妇就分娩方式的风险和益处进行仔细和周到的咨询是谨慎的，关于SU妊娠女性的分娩管理仍然存在争议。本文通过从SU阴道分娩影响因素角度分析，为日后SU阴道分娩提供参考，提高母婴保障。更多还原

【Abstract】 The rate of cesarean section in China has been high,and the increase of cesarean section rate leads to the increase of scar uterus (SU).With the opening of the national fertility policy,the choice of delivery mode for re-pregnancy after cesarean section has become an important issue for obstetricians,pregnant women can choose trial of labor after cesarean (TOLAC) or elective repeat cesarean section (ERCS).Compared with TOLAC,ERCS has more complications,such as secondary uterine injury,scar diverticulum,uterine scar pregnancy,etc,vaginal delivery can reduce the occurrence of these complications.However,the success of SU vaginal delivery is affected by many factors,careful and thoughtful consultation on the risks and benefits of delivery methods for pregnant women with previous SU is prudent,and there is still controversy about the delivery management of SU pregnant women.This article provided a reference for SU vaginal delivery in the future and improved maternal and child protection by analyzing the influencing factors of SU vaginal delivery.更多还原