Obstetric outcomes associated with induction of labour after caesarean section

Gobillot, S.; Ghenassia, Adrien; Coston, Anne-Laure; Gillois, Pierre; Equy, V.; Michy, Thierry; Hoffmann, P.

doi:10.1016/j.jogoh.2018.09.006

Cited by 19 publications

(39 citation statements)

References 20 publications

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“…They demonstrated that a Bishop score ≥ 6 has an odds ratio of 4.66 for successful VBAC deliveries. 32 The factors associated with successful TOLAC determined in the current work have also been found by other studies. In our study, the Bishop scores were significantly higher and the birth weights were significantly lower in the successful TOLAC group.…”

Section: Discussionsupporting

confidence: 82%

The Obstetrics Outcomes of Vaginal Birth After Cesarean Section in a Cohort with High Induction of Labor Rate

Takmaz¹,

Dural²,

Gorchiyeva³

et al. 2020

J Clin Obstet Gynecol

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Our primary objective is to evaluate the short-term maternal and perinatal results associated with the mode of delivery after cesarean section (CS). A second objective is to investigate the factors governing the success of trial of labor after cesarean (TOLAC). Material and Methods: In this retrospective cohort study, 126 singleton cephalic deliveries of women who had a history of one CS delivery were analyzed. The patients were divided into two groups: those who underwent TOLAC (n=31) and those who underwent elective repeat cesarean section (n=95). Delivery data, demographics, obstetric and medical history, intrapartum events, and maternal and perinatal outcomes were assessed. Results: The rate of successful vaginal birth after cesarean among the women who chose TOLAC was 64.5%. The groups were similar to each other with regard to maternal and perinatal complications. According to the current pregnancy characteristics of the patients with successful and failed vaginal delivery attempts; there were statistically significant differences between the groups in terms of Bishop scores and birth weights. The Bishop scores were higher in the successful TOLAC group (3.5 vs. 1; p=0.001). However, the birth weights were lower in the successful TOLAC group (3393±395 vs. 3708±430; p=0.049). The rate of spontaneous labor was higher in the successful TOLAC group, although it did not reach statistical significance. Conclusion: TOLAC is a farily safe procedure for selected pregnant women with one previous cesarean sections. It should be offered to all suitable pregnant women in order to reduce high CS rate and prevent complication associated with higher order repeat cesarean.

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Section: Discussionsupporting

confidence: 82%

The Obstetrics Outcomes of Vaginal Birth After Cesarean Section in a Cohort with High Induction of Labor Rate

Takmaz¹,

Dural²,

Gorchiyeva³

et al. 2020

J Clin Obstet Gynecol

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“…The risk of rupture is even higher if oxytocin is used to augment labour, irrespective of whether it is used to induce labour (2.2%) or used after spontaneous onset of labour (1.7%) 41 ; when PGE 2 and oxytocin are applied sequentially, the risk of rupture is up to 16 times higher 44 . Oxytocin should not be used in women with unripe cervix (BS < 6) because it is not sufficiently effective 35 and is also associated with a 3–4 times higher risk of rupture compared to oxytocin applied in women with ripe cervix 4 8 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Noch höher ist das Rupturrisiko, wenn Oxytocin zur Wehenverstärkung sowohl bei der Geburtseinleitung (2,2 %) als auch nach spontanem Wehenbeginn (1,7 %) gegeben wird [41]; bei sequenzieller Applikation von PGE 2 und Oxytocin ist das Rupturrisiko um das bis zu 16-Fache gesteigert [44]. Bei unreifer Zervix (BS < 6) sollte Oxytocin nicht eingesetzt werden, einerseits aufgrund der unzureichenden Effizienz [35], andererseits wegen der um das 3-bis 4fach höheren Rupturgefahr im Vergleich zur Anwendung von Oxytocin bei reifer Zervix [4,8,9]. Misoprostol ist nach Leitlinien [6,11,16] zur Geburtseinleitung nach Sectio kontraindiziert, da das Rupturrisiko bei im Mittel 6,2 % (0-18 %) liegt [10].…”

Section: Diskussionunclassified

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Mechanical Methods for the Induction of Labour After Previous Caesarean Section – An Updated, Evidence-based Review

Rath

Hellmeyer

Tsikouras

et al. 2022

Geburtshilfe Frauenheilkd

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There are currently no up-to-date evidence-based recommendations on the preferred method to induce labour after previous Caesarean section, especially for patients with unripe cervix, as randomised controlled studies are lacking. Intravenous oxytocin and misoprostol are contraindicated in these women because of the high risk of uterine rupture. In women with ripe cervix (Bishop Score > 6), intravenous administration of oxytocin is an effective procedure with comparable rates of uterine rupture to those with spontaneous onset of labour. Vaginal prostaglandin E2 (PGE2) and mechanical methods (balloon catheters, hygroscopic cervical dilators) are effective methods to induce labour in pregnant women with unripe cervix and previous Caesarean section. According to current guidelines, the administration of PGE2 is associated with a higher rate of uterine rupture compared to balloon catheters. Balloon catheters are therefore a suitable alternative to PGE2 to induce labour after previous Caesarean section, even though this is an off-label use. In addition to two meta-analyses published in 2016, 12 mostly retrospective cohort/observational studies with low to moderate levels of evidence have been published on mechanical methods of cervical ripening after previous Caesarean section. But because of the significant heterogeneity of the studies, substantial differences in study design, and insufficient numbers of pregnant women included in the studies, it is not possible to make any evidence-based recommendations based on these studies. According to a recent meta-analysis, the average rate using balloon catheters is approximately 53% and the average rate after spontaneous onset of labour is 72%. The uterine rupture rate was 0.2–0.9% for vaginal PGE2 and 0.56–0.94% for balloon catheters and is therefore comparable to the uterine rupture rate associated with spontaneous onset of labour. According to the product informations, hygroscopic cervical dilators (Dilapan-S) are currently the only method which is not contraindicated for cervical ripening/induction of labour in women with previous Caesarean section, although data are insufficient. Well-designed, randomised, controlled studies with sufficient case numbers comparing balloon catheters and hygroscopic cervical dilators with mechanical methods and vaginal prostaglandin E2/oral misoprostol are therefore necessary to allow proper decision-making.

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“…When labour progress deviates significantly from the alert line or when the action line in the partograph is crossed, artificial rupture of membranes, also called amniotomy, and augmentation of labour with oxytocin are the recommended interventions to manage prolonged labour [ 14 , 21 , 22 ]. A relative contra-indication for oxytocin use is a previous caesarean scar, which necessitates frequent monitoring and awareness of the risk of uterine scar rupture [ 23 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

Management of prolonged first stage of labour in a low-resource setting: lessons learnt from rural Malawi

Bakker

Dorp

Kazembe³

et al. 2021

BMC Pregnancy Childbirth

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Background Caesarean sections without medical indication cause substantial maternal and perinatal ill-health, particularly in low-income countries where surgery is often less safe. In presence of adequate labour monitoring and by appropriate use of evidence-based interventions for prolonged first stage of labour, unnecessary caesarean sections can be avoided. We aim to describe the incidence of prolonged first stage of labour and the use of amniotomy and augmentation with oxytocin in a low-resource setting in Malawi. Methods Retrospective analysis of medical records and partographs of all women who gave birth in 2015 and 2016 in a rural mission hospital in Malawi. Primary outcomes were incidence of prolonged first stage of labour based on partograph tracings, caesarean section indications and utilization of amniotomy and oxytocin augmentation. Results Out of 3246 women who gave birth in the study period, 178 (5.2%) crossed the action line in the first stage of labour, of whom 21 (11.8%) received oxytocin to augment labour. In total, 645 women gave birth by caesarean section, of whom 241 (37.4%) with an indication ‘prolonged first stage of labour’. Only 113 (46.9%) of them crossed the action line and in 71/241 (29.5%) membranes were still intact at the start of caesarean section. Excluding the 60 women with prior caesarean sections, 14/181 (7.7%) received oxytocin prior to caesarean section for augmentation of labour. Conclusion The diagnosis prolonged first stage of labour was often made without being evident from labour tracings and two basic obstetric interventions to prevent caesarean section, amniotomy and labour augmentation with oxytocin, were underused.

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Obstetric outcomes associated with induction of labour after caesarean section

Cited by 19 publications

References 20 publications

The Obstetrics Outcomes of Vaginal Birth After Cesarean Section in a Cohort with High Induction of Labor Rate

The Obstetrics Outcomes of Vaginal Birth After Cesarean Section in a Cohort with High Induction of Labor Rate

Mechanical Methods for the Induction of Labour After Previous Caesarean Section – An Updated, Evidence-based Review

Management of prolonged first stage of labour in a low-resource setting: lessons learnt from rural Malawi

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