Elective section after two sections—where's the evidence?

Roberts, Lawrence

doi:10.1111/j.1471-0528.1991.tb15388.x

Cited by 9 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After exclusion of case reports 33,36 and review articles, 37,38 26 studies were assessed further. Four publications reflected the same cohort 25,[39][40][41] and two publications each reflected same cohort [17][18][19][20]24,42 the most comprehensive publications relevant to our subject were chosen from each cohort.…”

Section: Resultsmentioning

confidence: 99%

Vaginal birth after two caesarean sections (VBAC‐2)—a systematic review with meta‐analysis of success rate and adverse outcomes of VBAC‐2 versus VBAC‐1 and repeat (third) caesarean sections

Tahseen

Griffiths

2009

BJOG

155

112

View full text Add to dashboard Cite

Background Trial of vaginal birth after Caesarean (VBAC) is considered acceptable after one caesarean section (CS), however, women wishing to have trial after two CS are generally not allowed or counselled appropriately of efficacy and complications.Objective To perform a systematic review of literature on success rate of vaginal birth after two caesarean sections (VBAC-2) and associated adverse maternal and fetal outcomes; and compare with commonly accepted VBAC-1 and the alternative option of repeat third CS (RCS).Search strategy We searched MEDLINE, EMBASE, CINAHL, Cochrane Library, Current Controlled Trials, HMIC Database, Grey Literature Databases (SIGLE, Biomed Central), using search terms Caesarean section, caesarian, C*rean, C*rian, and MeSH headings 'Vaginal birth after caesarean section', combined with second search string two, twice, second, multiple.Selection criteria No randomised studies were available, case series or cohort studies were assessed for quality (STROBE), 20/23 available studies included.Data collection and analysis Two independent reviewers selected studies and abstracted and tabulated data and pooled estimates were obtained on success rate, uterine rupture and other adverse maternal and fetal outcomes. Meta-analyses were performed using RevMan-5 to compare VBAC-1 versus VBAC-2 and VBAC-2 versus RCS.Main results VBAC-2 success rate was 71.1%, uterine rupture rate 1.36%, hysterectomy rate 0.55%, blood transfusion 2.01%, neonatal unit admission rate 7.78% and perinatal asphyxial injury/death 0.09%. VBAC-2 versus VBAC-1 success rates were 4064/5666 (71.1%) versus 38 814/50 685 (76.5%) (P < 0.001); associated uterine rupture rate 1.59% versus 0.72% (P < 0.001) and hysterectomy rates were 0.56% versus 0.19% (P = 0.001) respectively. Comparing VBAC-2 versus RCS, the hysterectomy rates were 0.40% versus 0.63% (P = 0.63), transfusion 1.68% versus 1.67% (P = 0.86) and febrile morbidity 6.03% versus 6.39%, respectively (P = 0.27). Maternal morbidity of VBAC-2 was comparable to RCS. Neonatal morbidity data were too limited to draw valid conclusions, however, no significant differences were indicated in VBAC-2, VBAC-1 and RCS groups in NNU admission rates and asphyxial injury/neonatal death rates (Mantel-Haenszel).Conclusions Women requesting for a trial of vaginal delivery after two caesarean sections should be counselled appropriately considering available data of success rate 71.1%, uterine rupture rate 1.36% and of a comparative maternal morbidity with repeat CS option.Keywords Complications, uterine rupture, vaginal birth after two caesarean sections.Please cite this paper as: Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections.

show abstract

Section: Resultsmentioning

confidence: 99%

Vaginal birth after two caesarean sections (VBAC‐2)—a systematic review with meta‐analysis of success rate and adverse outcomes of VBAC‐2 versus VBAC‐1 and repeat (third) caesarean sections

Tahseen

Griffiths

2009

BJOG

155

112

View full text Add to dashboard Cite

show abstract

“…In early times, all patients who had undergone caesarean section were subjected to elective caesarean section for their subsequent deliveries. 11,12 However in current set-up the situation has changed and vaginal birth after caesarean section has become an acceptable alternative. This is also referred as trial of labour or trial of scar.…”

Section: Introductionmentioning

confidence: 99%

“…This is also referred as trial of labour or trial of scar. 8,[11][12][13][14] The World Health Organization has projected a target that caesarean section rate should be up to 15%. 15 In today's times rate of caesarean section has increased many times due to various reasons.…”

Section: Introductionmentioning

confidence: 99%

Study of adequacy of informed consent in caesarean section in a tertiary care, teaching and research institute of Northern India

Latika

Nanda

Duhan

et al. 2015

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

“…3 In early times, all the patients who had undergone caesarean section were subjected to elective caesarean section for their subsequent deliveries. 4,5 But in recent times, the practice has changed and vaginal births after caesarean section has become an acceptable alternative. 6 Some factors like availability of trained surgeon, blood transfusion facilities and safe anaesthetic facilities affect the decision of opting for caesarean section.…”

Section: Introductionmentioning

confidence: 99%

A study of adequacy of informed consent before caesarean section in a tertiary care hospital

Bhushan

Manhas

2022

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Informed consent is an ethical and legal requirement and is practiced before all the surgical procedures. Caesarean section is the commonest obstetric surgery so, this study was aimed to assess the adequacy of informed consent in patients who underwent caesarean section at SMGS Hospital, GMC, Jammu.Methods: A cross-sectional study was done. A total of 230 patients were included in the study. A pre-tested and pre-validated questionnaire was used for the study. The data were expressed as percentage of proportion.Results: 230 patients participated in the study. About 96.95% patients knew the name of the procedure. 91.73% patients were informed about the indication of the surgery. 95.21% of the patients were aware about the benefits of surgery and about 93.41% of the patients were knowing risks of surgery. About 83.04% patients were informed about the procedure of the surgery. About 94.78% and 94.34% of the patients were aware about the need for the blood transfusion and future pregnancy options. Only about 4.35% of the patients were informed about the requirement and type of anaesthesia. 22.18% of the patients knew about the choice for alternate procedure and merely 2.18% of the patients were informed about the right to refuse the procedure.Conclusions: It was found that majority of the patients were well informed about the procedure and the related consequences. Still we can improve some elements of the consent process which can be done by proper awareness and training of health care professionals.

show abstract

Elective section after two sections—where's the evidence?

Cited by 9 publications

References 16 publications

Vaginal birth after two caesarean sections (VBAC‐2)—a systematic review with meta‐analysis of success rate and adverse outcomes of VBAC‐2 versus VBAC‐1 and repeat (third) caesarean sections

Vaginal birth after two caesarean sections (VBAC‐2)—a systematic review with meta‐analysis of success rate and adverse outcomes of VBAC‐2 versus VBAC‐1 and repeat (third) caesarean sections

Study of adequacy of informed consent in caesarean section in a tertiary care, teaching and research institute of Northern India

A study of adequacy of informed consent before caesarean section in a tertiary care hospital

Contact Info

Product

Resources

About