Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery

Landon, Mark B.; Hauth, John C.; Leveno, Kenneth J.; Spong, Catherine Y.; Leindecker, Sharon; Varner, Michael W.; Moawad, Atef H.; Caritis, Steve N.; Harper, Margaret; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Mick; Peaceman, Alan M.; OʼSullivan, Mary J.; Sibai, Bahaeddine M; Langer, Oded; Thorp, John M.; Ramin, Susan M.; Mercer, Brian M.; Gabbe, Steven G.

doi:10.1056/nejmoa040405

Cited by 1,215 publications

(870 citation statements)

References 8 publications

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“…This disagrees with a study which recorded hypoxic-ischemic encephalopathy occurred in no infants in ERCS and in 12 infants in TOL group [18]. This contradiction can be explained by that our women did RCS after failed VBAC thus more exhausted infants needed NICU admission while cesarean sections in their study were planned ERCS.…”

Section: Discussioncontrasting

confidence: 52%

Optimization of clinical outcome of women with previous one lower segment cesarean section

Eskandar¹,

Aboud²,

Alshahrani³

et al. 2012

OJOG

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Background and Objectives: To investigate the outcome in women with planned Vaginal Birth After Cesarean (VBAC) in comparison to Repeat Cesarean Section (RCS) and to those undergoing vaginal birth. Design and Settings: Retrospective study, women with a history of one lower segment cesarean section (LSCS) admitted to Abha General Hospital for delivery from September, 2010 to February, 2011. Subjects and Methods: The demographic maternal and neonatal data and data concerning the course of delivery were reviewed in 418 women underwent trial of labor (TOL) and subjected to statistical analysis to study the predictive factors and outcome. All cases were divided into 3 groups, VBAC group (212 women), RCS group (206 women) and the neonates of the VBAC group were compared to those of a control group consists of 287 neonates who were delivered vaginally. Results: The success rate of VBAC was 50.72%, with no uterine rupture or wound dehiscence. Failure to progress was the most common (40.2%) indication of RCS followed by fetal distress (29.9%). Young maternal age (P < 0.05), previous vaginal deliveries after CS (P < 0.05) and occiput anterior position (P < 0.01) were significantly associated with successful VBAC. Neonatal Intensive Care Unit (NICU) admission was significantly higher in the RCS group (P < 0.001), while no significant difference was found between NICU admission in the VBAC and the control groups. Conclusion: VBAC should remain an available option. Informed consent, good reporting and thorough documentation of the VBAC decision are crucial. During TOL, continuous fetal monitoring and, ultrasound evaluation of the previous scar are recommended. Emergency CS should be considered if duration of the TOL is prolonged with non reassuring CTG.

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Section: Discussioncontrasting

confidence: 52%

Optimization of clinical outcome of women with previous one lower segment cesarean section

Eskandar¹,

Aboud²,

Alshahrani³

et al. 2012

OJOG

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“…In the same study, the prevalence of coexisting placenta previa and accreta was also investigated, in a patient with placenta previa who undergo no CD had a 5% risk of developing placenta accreta, whereas in patients with previous CDs this rate was 24% and increased to 67% for patients with their third and fourth CD [26]. Again, many researchers have argued that there is a close relationship between the number of cesarean deliveries and placenta previa [21,27,28]. Several researchers show that there is a close correlation between the number of cesarean deliveries and abnormal placental invasion [7].…”

Section: Discussionmentioning

confidence: 99%

The effect of increased number of cesarean on maternal and fetal outcomes

Çintesun

2017

Ginekol Pol

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Objectives: The aim of this study was to evaluate the effects of multiple cesarean deliveries (CDs) on maternal-fetal morbidity and mortality rates. Material and methods:This retrospective study included a total of 1,506 patients who underwent multiple CDs between January 2006 and May 2014. The patients were divided into two groups. One group consisted of patients with four or more CDs (n = 444) and a control group of patients with three CDs (n=1,062). Both groups were analyzed for demographics, complications from multiple cesarean deliveries and perinatal outcomes. Results:The mean age was higher in the study group (p < 0.001). Dense adhesion (p < 0.001), demand for tubal ligation (p < 0.001), the requirement of pelvic drainage (p < 0.001), duration of hospitalization (p < 0.001) and the requirement for blood transfusion (p=0.03) was also significantly higher in the study group. Hemoglobin levels (p = 0.002) were significantly higher in the control group on the second postoperative day. Regarding perinatal morbidity; umbilical artery pH results (p = 0.003) were significantly lower in the study group. There was no significant difference in the maternal and fetal mortality rates between both groups.Conclusions: According to our study results, an increase in the number of cesarean sections increases maternal and fetal morbidity rates significantly. Therefore, we recommend decreasing the rate of primary cesarean deliveries by encouraging vaginal birth after CD. We also advocate the use of permanent contraceptive methods in patients with a high number of CD's. Further large-scale prospective results are required to establish a definitive conclusion.

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“…Uterine rupture was defined as a disruption of the uterine muscle extending to and involving the uterine serosa or disruption of the uterine muscle with extension to the bladder or broad ligament, while uterine dehiscence was defined as disruption of the uterine muscle with intact uterine serosa. 13 Factors affecting the success rate of VBAC, such as a previous normal vaginal delivery and Bishop scores, were also studied; the Bishop scoring system used included five determinants-dilatation, effacement, station, position and consistency. 14 The Statistical Package for the Social Sciences (SPSS), Version 19 (IBM Corp., Chicago, Illinois, USA) was used for data entry and analysis.…”

Section: Methodsmentioning

confidence: 99%

Use of Intracervical Foley Catheter for Induction of Labour in Cases of Previous Caesarean Section: Experience of a single tertiary centre in Oman

Gonsalves¹,

Al-Riyami²,

Al-Dughaishi³

et al. 2016

SQUMJ

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abstract:Objectives: This study aimed to evaluate rates of success and perinatal complications of labour induction using an intracervical Foley catheter among women with a previous Caesarean delivery at a tertiary centre in Oman. Methods: This retrospective cohort study included 68 pregnant women with a history of a previous Caesarean section who were admitted for induction via Foley catheter between January 2011 and December 2013 to the Sultan Qaboos University Hospital, Muscat, Oman. Patient data were collected from electronic and delivery ward records. Results: Most women were 25-35 years old (76.5%) and 20 women had had one previous vaginal delivery (29.4%). The most common indication for induction of labour was intrauterine growth restriction with oligohydramnios (27.9%). Most women delivered after 40 gestational weeks (48.5%) and there were no neonatal admissions or complications. The majority experienced no complications during the induction period (85.3%), although a few had vaginal bleeding (5.9%), intrapartum fever (4.4%), rupture of the membranes (2.9%) and cord prolapse shortly after insertion of the Foley catheter (1.5%). However, no cases of uterine rupture or scar dehiscence were noted. Overall, the success rate of vaginal birth after a previous Caesarean delivery was 69.1%, with the remaining patients undergoing an emergency Caesarean section (30.9%). Conclusion: The use of a Foley catheter in the induction of labour in women with a previous Caesarean delivery appears a safe option with a good success rate and few maternal and fetal complications. Keywords

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Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery

Abstract: A trial of labor after prior cesarean delivery is associated with a greater perinatal risk than is elective repeated cesarean delivery without labor, although absolute risks are low. This information is relevant for counseling women about their choices after a cesarean section.

Cited by 1,215 publications

References 8 publications

Optimization of clinical outcome of women with previous one lower segment cesarean section

Optimization of clinical outcome of women with previous one lower segment cesarean section

The effect of increased number of cesarean on maternal and fetal outcomes

Use of Intracervical Foley Catheter for Induction of Labour in Cases of Previous Caesarean Section: Experience of a single tertiary centre in Oman

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