Objective To analyze the influencing factors of vaginal birth after cesarean (VBAC) in re-pregnancy puerperae and mother-infant outcomes.Methods A total of 290 re-pregnant women after cesarean were enrolled in the study,and 210 pregnant women were successfully given vaginal delivery,among whom 180 cases with vaginal birth were selected as the observation group,and 80 cases with cesarean section were as control group.The factors affecting the success of vaginal delivery after cesarean section were analyzed,and the maternal and neonatal outcomes between the two groups were compared.Results The univariate analysis showed that fetal head position,fetal abdominal circumference,fetal biparietal diameter,uterine height,premature rupture of membranes,Bishop score,and epidural anesthesia of two groups were statistically significant(P ＜ 0.05);Multivariate logistic regression analysis showed that Bishop score,fetal abdominal circumference,fetal head position,and epidural anesthesia were independent influencing factors of VBAC success (P ＜ 0.05).The incidence rates of uterine rupture,the rate of neonatal asphyxia,hospitalization rate,Apgar score of two groups showed no significant difference (P ＞ 0.05).The bleeding rates at 2,24 h in the observation group were lower than that in the control group (P ＜ 0.05).Conclusion There are various factors that affect the success of vaginal delivery after cesarean section,and prenatal examination should be scientifically evaluated.If there is no indication of cesarean section,maternal vaginal delivery should be guided to improve the maternal and child outcomes and life quality of mother and child.

Objective To analyze the influencing factors of vaginal birth after cesarean (VBAC) in re-pregnancy puerperae and mother-infant outcomes.Methods A total of 290 re-pregnant women after cesarean were enrolled in the study,and 210 pregnant women were successfully given vaginal delivery,among whom 180 cases with vaginal birth were selected as the observation group,and 80 cases with cesarean section were as control group.The factors affecting the success of vaginal delivery after cesarean section were analyzed,and the maternal and neonatal outcomes between the two groups were compared.Results The univariate analysis showed that fetal head position,fetal abdominal circumference,fetal biparietal diameter,uterine height,premature rupture of membranes,Bishop score,and epidural anesthesia of two groups were statistically significant(P ＜ 0.05);Multivariate logistic regression analysis showed that Bishop score,fetal abdominal circumference,fetal head position,and epidural anesthesia were independent influencing factors of VBAC success (P ＜ 0.05).The incidence rates of uterine rupture,the rate of neonatal asphyxia,hospitalization rate,Apgar score of two groups showed no significant difference (P ＞ 0.05).The bleeding rates at 2,24 h in the observation group were lower than that in the control group (P ＜ 0.05).Conclusion There are various factors that affect the success of vaginal delivery after cesarean section,and prenatal examination should be scientifically evaluated.If there is no indication of cesarean section,maternal vaginal delivery should be guided to improve the maternal and child outcomes and life quality of mother and child.

Objective To explore the effects of the teaching model of "multi-subject cooperation integration" in training of independent learning ability among student nurses. Methods Two classes of four-year undergraduate nursing from a school of nursing in a university were selected as subjects by purposive sampling from September 2014 to January 2016. By lottery, class A (94 students) acted as observation group, while class B (94 students) acted as control group. Control group carried out routine teaching according to teaching program. On the basis of routine teaching, observation group developed the teaching model of"multi-subject cooperation integration" in sectional chapters of three major courses of nursing speciality. The independent learning ability was evaluated with the self-rating scale for self-directedness in learning (SRSSDL). Results After educational reform, the total score of SRSSDL and the scores of learning activities, evaluation of observation group were (230.21±24.75), (43.95±5.39), (45.97±5.95) higher than those [(222.60±24.24), (42.35±5.67), (43.06±5.78)]of control group with significant differences (t=0.033, 0.047, 0.001; P<0.05). Conclusions The teaching model of "multi-subject cooperation integration" can improve the independent learning ability of student nurses.