A woman's choice for delivery was often based on family obligations, such as the need for a shorter recovery so that she could care for her infant and children at home, rather than the safety of herself or her infant. It remains unclear if education on vaginal birth after cesarean increases the proportion of women who choose trial of labor. Future studies should evaluate the impact of education and timing of education on patient preference.

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We investigated the effect of fetal sheep ductus arteriosus occlusion (DO) on the distribution of cardiac output, and left (LV) and right (RV) ventricular function by tissue and pulsed Doppler at baseline, after 15 and 60 minutes of DO induced by a vascular occluder, and 15 minutes after DO was released. Ductal occlusion decreased fetal pO2. The mean LV output increased (p<0.001) from 725 to 1013 ml/min, and RV (1185 vs. 552 ml/min) and systemic (1757 vs. 1013 ml/min) cardiac outputs fell (p<0.001) after 15 minutes of DO, when compared to baseline. Pulmonary vascular impedance decreased and volume blood flow (QP) increased over 3-fold during DO, while foramen ovale volume blood flow (QFO) remained unchanged. LV systolic function was unaffected, while isovolumic relaxation velocity deceleration decreased. RV functional indices remained unchanged. We conclude that DO increased QP, not QFO. LV output increased, however not as much as RV output fell, resulting in decreased systemic cardiac output. During DO, LV exhibited diminished relaxation.