With the gradual liberalization of the policy of separate second birth in China, the rate of re-pregnancy after cesarean section has also increased, and scarred uterus now often takes the first place among the indications for repeat cesarean section. The management of pregnancy and delivery strategies after cesarean section has become an issue of great importance to obstetricians. In order to appropriately reduce the rate of repeat cesarean delivery and reasonably increase the rate of vaginal delivery, it is important to know as much information as possible about the scar status of the uterus. 1. Is a scarred uterus an absolute indication for cesarean delivery in the next pregnancy? If not, under what circumstances can vaginal delivery be attempted? What are the circumstances that require a second cesarean section? Vaginal re-birth after cesarean section is currently advocated, but there is a risk of uterine rupture during the trial of labor. The risk of uterine rupture is also a risk to the fetus, so a thorough evaluation is necessary, mainly based on the previous operation, the indications for the operation, the post-operative recovery and the interval between the previous operations, and the absence of complications and cephalopelvic disproportion in this pregnancy. 2.What is the process of uterine recovery and the common treatment of poor recovery? The recovery of the uterus after cesarean delivery is mainly related to the contraction of the uterus, that is, the situation of uterine rejuvenation. If there is postoperative infection or combined fibroids, fetal membrane residue, etc., it will affect the uterine recovery. If there is infection before the operation, or if there are fibroids, postoperative antibiotics to prevent infection must be adequate and in place, and at the same time with the use of drugs to promote uterine contraction, such as contraction or Chinese medicine nature of motherwort, biochemical soup, etc. 3, we know that postpartum hemorrhage is a common and serious complication of obstetrics, but also one of the main causes of maternal death. So what are the causes of postpartum hemorrhage, and how should we prevent and observe it? There are many causes of postpartum hemorrhage, but in general there are four major categories: weak contractions, placental factors (such as placental residue), birth canal lacerations and coagulation dysfunction. The most common is postpartum hemorrhage from premature labor due to weak uterine contractions, but the causes of weak uterine contractions are related to twin pregnancies, giant fetuses, and combined pre-eclampsia. The most serious causes of postpartum hemorrhage are central placenta praevia, placenta abruptio, and amniotic fluid embolism, etc. 4.How to prevent scar growth after cesarean delivery? The formation of scar is related to the surgical method and post-operative care, but also to the individual’s body type. If one is a keloid, surgical scarring is sometimes unavoidable. But from the surgeon’s point of view, it is important to avoid it as much as possible. First, reduce the tension suture, second, the postoperative wound should be moisturized, plus massage, a week to 10 days after surgery, at home to prevent scarring products, so that may reduce the formation of scarring. 5, we all know that there are two types of delivery: normal delivery and cesarean section, what is the difference between these two types of delivery and their postpartum care? In fact, the requirements for postpartum recovery are the same, but in the process of natural delivery, the uterus is trained to contract during delivery, so the postpartum recovery will be faster, while in cesarean delivery, there is no such process, so the uterus is relatively slow to recover. In addition, after a short period of super physical labor in normal delivery, after a few hours of rest, the strength can be recovered and you can move freely on the floor. Cesarean delivery, due to the limitations of the operation, requires a minimum of 24 hours of bed rest after delivery. Therefore, the elimination of malodex after cesarean delivery is slower, and the bed-resting position will prevent the baby from sucking milk, so sometimes the milk will decrease. Therefore, it is more important for mothers who had cesarean delivery to suckle early and stimulate the nipples in time to help milk secretion after delivery. 6, we know that cesarean delivery will lead to the problem of scarred uterus, scarred uterus will become a high-risk indicator of the next pregnancy, so the repair of the uterus after cesarean delivery is a matter of great concern, so what factors will affect the healing of the uterine incision? The healing of the uterine incision is related to the surgical suturing method and the individual’s physical condition. If the individual is anemic, hypoproteinemic, or malnourished, it can affect the healing of the incision. If it is not a planned surgery but a cesarean delivery after a long trial of vaginal delivery, the incision will be lacerated or the lower end stretched too thin and the sutures will not be easily aligned. Of course, it also has to do with the doctor’s suturing method to make sure that the stitches are consistently spaced at the upper and lower edges of the incision. It is important to ensure that the spacing between the upper and lower left and right stitches is consistent between each stitch, while actively aligning the lining well, and it would be better if the stitches are as neat as teeth afterwards. 7.With the relaxation of family planning policy, many people are considering to have another pregnancy and delivery, so is there anything to emphasize on the issue of scarred uterus? In previous years, there were too many cesarean deliveries, and now that the two-child policy has been liberalized, re-pregnancy after cesarean delivery is indeed an important issue. For pregnant women, the first thing to do is to keep track of the interval since the last pregnancy, preferably 2-3 years. Too close or too long, the degree of uterine scar muscularization will become worse. In addition, it is important to ensure normal weight gain after pregnancy, and try to avoid a huge fetus that overstretches the uterus and causes uterine rupture during pregnancy. Finally, it is important to have regular ultrasound examinations to observe the condition of the lower uterine segment, but do not rely too much on the thickness of the lower uterine segment alone to judge, but measure the continuity of the muscle layer of the lower uterine segment comprehensively.