Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery?

Cahill, Alison G.; Stamilio, David M.; Odibo, Anthony O.; Peipert, Jeffrey F.; Ratcliffe, Sarah J.; Stevens, Erika; Sammel, Mary D.; Macones, George A.

doi:10.1016/j.ajog.2006.06.045

Cited by 119 publications

(98 citation statements)

References 9 publications

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“…Also, 0.2%-0.7% risk of scar dehiscence in women undergoing TOLAC was reported in the literature and by Cahill and colleagues. 10,11 Uterine rupture is associated with an increased risk of severe maternal complications, such as hysterectomy, hemorrhage, as well as severe fetal complications, such as hypoxic ischemic encephalopathy and perinatal death". 12 The other important factor to consider in the setting of TOLAC or a uterine rupture is the neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting success of trial of labour after caesarean in current scenario

Singh

Bamaniya

Shah

2016

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Factors predicting success of trial of labour after caesarean in current scenario

Singh

Bamaniya

Shah

2016

Int J Reprod Contracept Obstet Gynecol

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“…The scar could be identified in only five patients with alteration in echogenicity of myometrium. In case of non-visualization of scar, measurements were taken at multiple sites (3)(4)(5) of the lower uterine segment and its thinnest portion was considered to be the scar. The area was evaluated in both transverse and sagittal planes but measurement was performed in sagittal plane in all patients to eliminate bias related to direction of ultrasonic waves.…”

Section: Methodsmentioning

confidence: 99%

“…Le misurazioni degli spessori della cicatrice sono state correlate con la modalità del parto. La cicatrice è stata misurata in più punti (3)(4) della parte inferiore dell'utero e la sua parte più sottile è stata considerata come la cicatrice. Risultati lo spessore della cicatrice era più sottile nelle pazienti che avrebbero avuto un parto cesareo rispetto a quelle con parto vaginale e questa differenza era statisticamente significativa, in entrambe le età gestazionali.…”

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Scar thickness measurement by transvaginal sonography in late second trimester and third trimester in pregnant patients with previous cesarean section: does sequential change in scar thickness with gestational age correlate with mode of delivery?

et al. 2014

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Purpose The objective of this study was to evaluate whether scar thickness measured by transvaginal sonography and the sequential change in scar thickness from second to third trimester has any association with mode of delivery in patients with previous cesarean. Methods Pregnant women with previous one cesarean section underwent transvaginal sonography between 24 and 28 weeks of gestation and then a repeat scan beyond 36 weeks of gestation to measure scar thickness. These scar thickness measurements were then correlated with the mode of delivery. The scar was measured at multiple sites (3-4) of the lower uterine segment and its thinnest portion was considered to be the scar. Result Scar thickness was thinner in those patients having cesarean delivery than those having vaginal delivery and this difference was statistically significant at both the gestational ages. Mean scar thickness at 24-28 weeks of gestation in patients who delivered vaginally is 4.8 ± 1.1 mm and in those who had repeat cesarean section is 4.4 ± 1.1 mm (p value = 0.043). Mean scar thickness beyond 36 weeks of gestation in patients who delivered vaginally is 3.3 ± 0.7 mm and in those who had repeat cesarean section is 2.9 ± 0.9 mm (p value = 0.003). The mean decrease in scar thickness was not significantly different between those who delivered vaginally (mean decrease = 1.73 ± 0.95 mm) and those who had a repeat cesarean (mean decrease = 1.91 ± 0.96 mm). Conclusion Our study concluded that thicker scars are associated with better chances of successful vaginal birth after cesarean. Measurement at both late second trimester and third trimester can be done but latter has better correlation with mode of delivery. This association may be explained by the fact that thinner scars have more chances of fetal bradycardia, meconium staining of liquor and previous cesarean for feto-pelvic disproportion.Keywords Transvaginal sonography Á Scar thickness Á VBAC Á Previous cesarean section Á Second trimester Riassunto Scopo obiettivo dello studio è valutare se lo spessore della cicatrice, misurata con ecografia transvaginale e il cambio di spessore della cicatrice dal secondo al terzo trimestre, sono correlati con la modalità del parto, in pazienti con pregresso parto cesareo. Metodi donne incinta, con pregresso parto cesareo, sono state sottoposte ad ecografia transvaginale tra la 24 a la 28 settimana di gestazione, poi ad un ulteriore esame oltre la 36 settimana di gestazione, per misurare lo spessore della cicatrice. Le misurazioni degli spessori della cicatrice sono state correlate con la modalità del parto. La cicatrice è stata Content: This study pertains to serial assessment of previous cesarean scar in antenatal period and whether it has a role in predicting successful VBAC.

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“…6 Keberhasilan VBAC sebesar 2,58 kali lebih tinggi pada wanita di bawah usia 40 tahun dibandingkan dengan 40 tahun atau lebih. 7 Insidensi ruptur uteri pada wanita <30 tahun dengan wanita >30 tahun berbeda yaitu 0,5% dan 1,4%.…”

Section: Pembahasanunclassified

Perbandingan Keberhasilan Vaginal Birth After a Cesarean (VBAC) pada Inersia Uteri Hipotonik dengan dan tanpa Pemberian Oksitosin Drip

Setiawan¹,

Krisnadi²,

Sabarudin³

2012

mkb

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AbstrakPercobaan persalinan per vaginam dapat menjadi pilihan untuk wanita yang sebelumnya pernah mengalami seksio sesarea. Percobaan yang berhasil dinamakan sebagai vaginal birth after a cesarean (VBAC). Kegagalan VBAC sering kali disebabkan karena terjadinya inersia uteri hipotonik. Augmentasi oksitosin drip bukan merupakan kontraindikasi, pemberian augmentasi oksitosin drip merupakan upaya untuk meningkatkan angka keberhasilan VBAC akan tetapi harus diberikan dengan pemantauan kontinu. Penelitian ini bertujuan untuk menentukan perbedaan keberhasilan VBAC pada inersia uteri hipotonik dengan dan tanpa pemberian oksitosin drip. Penelitian ini merupakan penelitian eksperimental dengan rancangan uji klinik acak terkontrol (randomized clinical trial), terhadap 40 penderita dengan riwayat seksio sesarea di Rumah Sakit Dr. Hasan Sadikin, Rumah Sakit Umum Daerah Sumedang, dan Rumah Sakit Astana Anyar yang memenuhi kriteria inklusi periode Maret-Mei 2009; dilakukan perbandingan dua kelompok, yaitu kelompok dengan oksitosin drip dan tanpa oksitosin drip. Karakteristik penderita, keberhasilan VBAC, dan komplikasi ibu serta keluaran neonatus dicatat sebagai data. Uji kemaknaan perbedaan dua proporsi dengan menggunakan chi-kuadrat. Hasil penelitian menunjukkan bahwa keberhasilan VBAC secara statistik tidak memperlihatkan perbedaan bermakna antara kelompok oksitosin drip (80%) dan tanpa oksitosin drip (60%) dengan nilai p=0,168 (p>0,05), tetapi dengan interval kepercayaan 95% keberhasilan VBAC dengan oksitosin drip lebih besar 1,71 (0,72-4,06). Komplikasi pada ibu dan neonatus yang timbul pada kedua kelompok tidak berbeda bermakna. Simpulan, pemberian oksitosin drip pada kasus inersia uteri hipotonik meningkatkan keberhasilan VBAC. [MKB. 2012;44(2):114-20]. Kata kunci: Inersia uteri hipotonik, oksitosin drip, vaginal birth after a cesarean (VBAC) The Successful Comparison of Vaginal Birth After a Cesarean (VBAC) on Hypotonic Uterine Inertia with and without Oxytocin Infusion AbstractTrial of labor after cesarean section can be a choice on maternity with cesarean history. The successful trial of labor is then called vaginal birth after a cesarean (VBAC). The failure on VBAC is often caused by hypotonic uterine inertia. Oxytocin infusion augmentation is not a contraindication; it is a solution for increasing success on VBAC with requisite continuing observation. The aim of this research was to determine the successful differences of VBAC on hypotonic uterine inertia with and without oxytocin augmentation. This research was an experimental study on randomized clinical trial, using 40 patients with history of cesarean section at Dr. Hasan Sadikin Hospital and two satellite hospitals (Sumedang and Astana Anyar) during March-May 2009 which fulfilled inclusion criteria divided into two groups; the group using oxytocin infusion and the group without oxytocin infusion. The patients' characteristic, the success on VBAC and the maternal complication also neonatal condition were noted as encode. Chi-square test was used for statistical...

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Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery?

Cited by 119 publications

References 9 publications

Factors predicting success of trial of labour after caesarean in current scenario

Factors predicting success of trial of labour after caesarean in current scenario

Scar thickness measurement by transvaginal sonography in late second trimester and third trimester in pregnant patients with previous cesarean section: does sequential change in scar thickness with gestational age correlate with mode of delivery?

Perbandingan Keberhasilan Vaginal Birth After a Cesarean (VBAC) pada Inersia Uteri Hipotonik dengan dan tanpa Pemberian Oksitosin Drip

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