Low risk pregnancies after a cesarean section: Determinants of trial of labor and its failure

Lehmann, Sjur; Baghestan, Elham; Børdahl, Per E.; Irgens, Lorentz M.; Rasmussen, Svein

doi:10.1371/journal.pone.0226894

Cited by 7 publications

(2 citation statements)

References 41 publications

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“…In a retrospective study published in 2020( 22 ), the authors investigated the effect of demographic, socioeconomic, and health system factors on TOLAC and TOLAC failure in low risk pregnancies, and their variation over time. Advanced maternal age was associated with both low TOLAC rates and high TOLAC failure, while ethnicity (women from East Asia, Latin America, non-western origin), education (<11 years of education) and health system factors (e.g., delivery unit size and administrative region) had a considerable effect on both TOLAC and TOLAC failure.…”

Section: Risk Factor Rankingmentioning

confidence: 99%

Risk management of vaginal birth after cesarean section (Review)

et al. 2021

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The increasing number of patients who desire to experience vaginal birth after cesarean (VBAC) and the optimized protocols for trial of labor after cesarean (TOLAC) has led to a shift of old obstetrical paradigms. The VBAC trend is accompanied with numerous challenges for healthcare professionals, from establishing suitability of each pregnant patient profile for TOLAC to active labor management, and ethical or legal issues, which occasionally are not included in specific guidelines. That is why an individualized risk assessment and management can serve obstetricians as a useful tool for improving outcomes of patients, satisfaction, and also for avoiding legal or moral liabilities. The risk management concept aims to reduce foreseen risks and to emulate strategies for prediction and prevention of unwanted events. In obstetrics, and particularly for the VBAC topic, this concept is relatively new and undefined, and thus its features are disparate between guideline recommendations and clinical studies. This narrative review intends to offer a new and organic perspective over clinical aspects of TOLAC and VBAC risk management.

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Section: Risk Factor Rankingmentioning

confidence: 99%

Risk management of vaginal birth after cesarean section (Review)

et al. 2021

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“…Therefore, for obstetricians, it is crucial to identify the potential protective and risk factors influencing a woman’s successful VBAC based on the patients’ baseline characteristics. Several studies have reported that patient demographic characteristics (patient race and ethnicity, education level and gestational week), 11 12 maternal factors (maternal age, body mass index, bishop score, diabetes, hypertensive disorders complicating pregnancy and previous vaginal deliver), 12–15 fetal factors (estimated birth weight) 16 and other related factors (oxytocin implementation) 15 that may be associated with a woman’s chance for successful VBAC. Some predictive models for successful VBAC have also been published in recent years.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting successful vaginal birth after caesarean section: protocol for evidence-based consensus recommendations using a Delphi survey

Zhu

Feng

et al. 2021

BMJ Open

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IntroductionWith the wide adoption of the two-child policy in China since 2016, a large percentage of women with a history of caesarean delivery plan to have a second child. Accordingly, the rate of vaginal birth after caesarean (VBAC) delivery is increasing. Women attempting repeat VBAC may experience multiple morbidities, which is also one of the leading causes of maternal and perinatal mortality. However, it remains to be addressed how we evaluate factors for successful VBAC. This study aims to use a novel approach to identify a set of potential predictive factors for successful VBAC, especially for Chinese women, to be included in prediction models which can be most applicable to pregnant women in China. We plan to assess all potential predictive factors collected through a comprehensive literature review. Then the certainty of the evidence for the identified potential predictive factors will be assessed using the Grading of Recommendations Assessment, Development and Evaluation process. Finally, a two-round international Delphi survey will be conducted to determine the level of consensus.Methods and analysisThis study will apply a methodology through an evidence-based approach. A long list of potential predictive factors for successful VBAC will be extracted and identified through the following stages: First, an up-to-date systematic review of the published literature will be conducted to extract identified potential predictive factors for successful VBAC. Second, an online Delphi survey will be performed to achieve expert consensus on which factors should be included in future prediction models. The online questionnaires will be developed in the field of patient, maternal and fetal-related factors. A two-round international Delphi survey will be distributed to the expert panel in the field of perinatal medicine using Google Forms. Experts will be asked to score each factor using the 9-point Likert rating scale to establish potential predictive factors for the successful VBAC. The expert panel will determine on whether to include, potentially include or exclude predictive factors, based on a systematic review of clinical evidence and the Delphi method.Ethics and disseminationThe study was approved by the Institutional Review Board of the Jiaxing Maternity and Children Healthcare Hospital (approval number: 2019–79). The results of this study will be submitted to international peer-reviewed journals or conferences in perinatal medicine or obstetrics.

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Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study

Tegegne,

Rade,

Yismaw

et al. 2024

BMC Pregnancy Childbirth

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Background Trials of labor after cesarean section is the preferred strategy to decrease the cesarean delivery rate and reducing complications associated with multiple cesarean sections. The success rate of trials of labor after cesarean section and associated factors have not been well documented in Ethiopia. Hence, this study was aimed to determine the success rate and factors associated with the trial of labor after one cesarean section in five Comprehensive Specialized Hospitals located in northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among 437 women who came for the trial of labor from December 1, 2021, to March 30, 2022. All women who fulfilled the eligibility criteria were included to this study. Data was collected using structured and pre-tested questionnaire. Then, the data was entered into Epi Data 4.6 software and exported to SPSS version 26 for analysis. To identify the variables influencing the outcome variable, bivariable and multivariable logistic regression analyses were conducted. The model’s fitness was checked using the Hosmer-Lemeshow goodness of fit test, and an adjusted odds ratio with a 95% confidence interval was used to declare the predictors that are significantly associated with TOLAC. Results The success rate of the trial of labor after one cesarean section was 56.3% (95% CI, 51.3%, 61.2%). Maternal age ≥ 35 years (AOR: 3.3, 95% CI 1.2, 9.3), the fetal station at admission ≤ zero (AOR: 5. 6, 95% CI 3.3, 9.5), vaginal delivery before cesarean section (AOR: 1.9, 95% CI 1.2, 3.2), and successful vaginal birth after cesarean delivery (AOR 2.2, 95% CI 1.2, 4.1) were found to have a significant association with the success rate of trial of labor after cesarean section. Conclusions In this study, the success rate of the trial of labor after a cesarean section was low as compared to the ACOG guideline and other studies in different countries. Therefore, the clinicians ought to offer counsel during antenatal and intrapartum period, encourage the women to make informed decision on the mode of delivery, and the practitioners need to follow fetal and maternal conditions strictly to minimize adverse birth outcomes.

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Low risk pregnancies after a cesarean section: Determinants of trial of labor and its failure

Cited by 7 publications

References 41 publications

Risk management of vaginal birth after cesarean section (Review)

Risk management of vaginal birth after cesarean section (Review)

Factors predicting successful vaginal birth after caesarean section: protocol for evidence-based consensus recommendations using a Delphi survey

Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study

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