How to boost an obstetrician's confidence in vaginal delivery after high-intensity focused ultrasound: a comparison study on delivery outcomes

Figures & data

Figure 1. Perinatal period: The perinatal period is the one extending from the gestational age at which the fetus attains the weight of 1000 g (equivalent to 28 completed weeks of gestation) to the end of the seventh completed day of life [27].

Table 1. Mother characteristics and pregnancy outcomes between two groups.

	Qualified Candidates for TOLAH	Candidates for TOLAC	P(t/x2/fisher)
Age	35.57 ± 4.81	33.24 ± 3.53	0.007
BMI	22.92 ± 3.36	21.75 ± 2.55	0.01
Parity ≥3	9/37 (24.32%)	195/368 (52.99%)	0.001
Pregnancy mode			0.000
Nature	32 (86.49%)	364 (98.91%)
Assistant	5 (13.51%)	4 (1.09%)
Fetus number			0.008
Singleton	35/37 (94.59%)	368/368 (100%)
Twins	2/37 (5.41%)	0(0%)
Bleeding before delivery	0	0
Rupture during pregnancy	0	0

Table 2. Delivery outcomes between two groups.

	Qualified Candidates for TOLAH	Candidates for TOLAC	P (t/x2/fisher)
Gestational age (days)	265.97 ± 11.45	271.83 ± 12.01	0.022
Delivery mode			0.000
Vaginal delivery (VD)	1 (2.70%)	234 (63.59%)
Cesarean (CS)	36 (97.30%)	134 (36.41%)
Preterm	1/37 (2.70%)	36/368 (9.78%)	0.124
Fetal
Weight	3173.65 ± 746.75	3261.40 ± 494.22	0.488
Apgar	9.19 ± 0.46	9.26 ± 1.33	0.745
Placental abnormality			0.812
Adherent placenta	3	39
Placenta previa/low	0	10
Placenta implantation	0	0
Placental abruption	0	3
PPH
≥ 500	3/34 (8.82%)	35/333 (10.51%)	0.534
≥ 1000	0/37 (0%)	9/359 (2.51%)	0.418
>710	0/37 (0%)	19/349 (5.44%)	0.155
Average blood loss
Obstetricians' assessment (ml)	359.86 ± 99.376	383.23 ± 180.47	0.439
Hb drop (g/l)	7.03 ± 7.39	12.11 ± 12.62	0.001
Uterine contraction			0.072
Normal	24 (64.86%)	187 (50.82%)
Abnormal	13 (35.14%)	181 (49.18%)
Uterotonic medications			0.04
≤ 2 types*	17 (45.95%)	111 (30.16%)
≥ 3 types**	20 (54.05%)	257 (69.84%)
Blood transfusion	0/37 (0%)	13/368 (3.53%)	0.282
Bakri	1/37 (2.70%)	9/368 (2.45%)	0.621
Surgical procedure
Uterine artery ligation	13/37 (35.14%)	28/368 (7.61%)	0.000
Uterine compression sutures	2/37 (5.41%)	9/368 (2.45%)	0.265
Rupture during delivery	0/37 (0%)	2/368 (0.54%)	0.825

Uterotonic medications: *the two basic types are oxytocin (10 IU, IM) and carbetocin (100 μg, IV), **other supplemental types are carboprost tromethamine injection (250 μg, IM) and carboprost suppository (2 mg, SL).

Table 3. Multivariable regression analysis PPH (blood loss ≥500).

	aOR	95%CL	p Value
Age	1.098	0.991 ∼ 1.218	0.075
BMI	1.105	0.240 ∼ 5.087	0.898
Parity	0.601	0.374 ∼ 0.966	0.036
Weeks	0.983	0.951 ∼ 1.016	0.322
Fetal weight	1.000	1.000 ∼ 1.001	0.329
Placental abnormality	0.570	0.223 ∼ 1.460	0.242
Abnormal contraction	17.177	5.046 ∼ 58.472	0.000
Cs	1.547	0.678 ∼ 3.527	0.300
After HIFU	1.105	0.240 ∼ 5.087	0.898
Pregnancy mode	0.678	0.103 ∼ 4.450	0.686

WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet. Gynecol Scand. 1977;56:247–253.

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Data availability statement

The data that support the findings of this study are openly available in Science Data Bank at https://www.scidb.cn/anonymous/Yk12SUpq