Elective Repeat Cesarean Delivery Versus Trial of Labor

Flamm, Bruce L.; Goings, Janice R.; Liu, Yun‐Bao; Wolde-Tsadik, Girma

doi:10.1097/00006250-199406000-00005

Cited by 240 publications

(121 citation statements)

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“…After screening by titles and abstracts, 308 non-relevant studies were excluded and the full texts of 20 articles were assessed. Of these, four were excluded, the reasons for which are shown in Figure 1; thus, 16 studies were included in the meta-analysis [6,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Section: Literature Searchmentioning

confidence: 99%

Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery

Yang

Sun

2017

CIM

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Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery Abstract Purpose: The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD).Source: Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth. Randomized controlled trials (RCTs), two-arm prospective studies, one-arm studies and retrospective studies were included. The primary outcome was uterine rupture.Principal findings: Sixteen studies were included in the meta-analysis. TOL after prior Cesarean delivery was associated with higher odds of uterine rupture as compared with ERCD (Peto odds ratio [OR] = 4.685, 95% confidence interval [CI]: 3.077 to 7.133, p < 0.001). TOL was associated with a higher rate of endometritis, a lower rate of hysterectomy, and a lower rate of respiratory problems in newborns. There were no differences between the groups with respect to neonatal intensive care unit admissions, postpartum hemorrhage, thromboembolic disease, sepsis and neonatal mortality.Conclusions: TOL may be associated with a higher risk of uterine rupture and endometritis, but lower risk of hysterectomy and neonatal respiratory problems than ERCD.

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Section: Literature Searchmentioning

confidence: 99%

Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery

Yang

Sun

2017

CIM

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“…[1][2][3][4][5] There are various signs and symptoms associated with uterine rupture. Classically, these include loss of station of the presenting part, an altered uterine contour, cessation of labor, uterine hypertonus, vaginal bleeding, fetal distress, and abdominal pain.…”

Section: Casementioning

confidence: 99%

“…[1][2][3][4] Uterine rupture, the most serious complication, occurs in approximately 0.5 to 0.8% of labor trials involving parturients with a prior low transverse cesarean scar. In 15 to 20% of rupture cases, potentially serious maternal or fetal morbidity occurs.…”

Section: Introductionmentioning

confidence: 99%

Vernixuria: Another Sign of Uterine Rupture

2003

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Uterine rupture complicates approximately 1% of trials of labor after cesarean. Classic signs and symptoms include loss of station, cessation of labor, vaginal bleeding, fetal distress, and abdominal pain. Other signs are also possible. We report a case of uterine rupture at VBAC trial that includes an unusual clinical sign of uterine rupture: vernix caseosa observed in the urine of the parturient. During labor, a bladder catheter was inserted to evaluate oliguria. Vernix caseosa and blood were found in the tubing. Prompt cesarean delivery followed. A tear extending from the original transverse scar into the bladder dome was found. Vernixuria is an additional sign of uterine rupture.

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“…[2][3][4] Several studies both in developed and developing countries have shown that it is not only feasible but safe. [4][5][6][7] Among women who attempt a trial of labor after a previous cesarean section, 60% to 80% have a vaginal delivery, [8][9][10][11] and morbidity is lower among women who have a vaginal delivery after a previous cesarean section than among women who elect to undergo a second cesarean section. 9,12,13 Although trial of labor is usually successful and relatively safe, it may occasional be associated with severe maternal morbidity and even mortality and correct management represents one of the most significant and challenging issues in obstetric practice.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] Among women who attempt a trial of labor after a previous cesarean section, 60% to 80% have a vaginal delivery, [8][9][10][11] and morbidity is lower among women who have a vaginal delivery after a previous cesarean section than among women who elect to undergo a second cesarean section. 9,12,13 Although trial of labor is usually successful and relatively safe, it may occasional be associated with severe maternal morbidity and even mortality and correct management represents one of the most significant and challenging issues in obstetric practice. 4,7 With this background the study was conducted prospectively to study the maternal morbidity and mortality amongst women who underwent a trial of labor after a previous cesarean delivery at tertiary care teaching hospitals in India.…”

Section: Introductionmentioning

confidence: 99%