Predicting the success of vaginal birth after caesarean delivery: a retrospective cohort study in China

Li, Yunxiu; Bai, Zhi; Long, Da-Jian; Wang, Haibo; Wu, Yangfeng; Reilly, Kathleen H.; Huang, Suran; Ji, Yan-Jie

doi:10.1136/bmjopen-2018-027807

Cited by 51 publications

(54 citation statements)

References 22 publications

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“…Almost all studies reveal the previous vaginal birth was found to be a strong predictor [2,3,9]. In our study, 96.4% of women with history of vaginal delivery had successful TOLAC.…”

Section: Discussionsupporting

confidence: 50%

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Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean

Uno

Mayama

Yoshihara

et al. 2020

BMC Pregnancy Childbirth

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Background: Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. To reveal the safety and feasibility of TOLAC, we conducted this observational, prospective study with women's independent decisions. We aimed to clarify the relationship between their chosen mode of delivery and the reason for their previous Cesarean. Additionally, we have tried to identify maternal and obstetric factors associated with failed TOLAC to improve its success rate. Methods: This was a prospective, observational study of 1086 pregnant women with at least one previous Cesarean delivery. Of these, 735 women met our TOLAC criteria (Table 1), and then, could choose TOLAC or repeat Cesarean after receiving detailed explanations regarding the risks and benefits of both procedures. The primary outcomes were the number of successful TOLAC procedures and 5-min Apgar scores < 7 for the trial of labor after Cesarean group and elective Cesarean group. We collected the maternal and neonatal data including the reasons of previous Cesarean. Results: In total, 64.1% of women chose TOLAC. The success rate was 91.3%. The uterine rupture rate was 0.6%. There were no significant differences in the rate of Apgar scores at 5 min < 7 between both groups. Histories of experience of labor in previous Cesarean delivery were observed in 30 and 50% of women who chose TOLAC and repeat Cesarean, respectively (p < 0.05). Factors related to failed TOLAC included ≥40 weeks of gestation (odds: 5.47, 95% CI: 2.55-11.70) and prelabor rupture of membranes (PROM) (odds: 4.47, 95% CI: 2.07-9.63).Conclusions: TOLAC is a favorable delivery option for both mothers and neonates when women meet criteria and choose after receiving detailed explanations. Women who experience PROM or ≥ 40 weeks of gestation, their modes of delivery should be reconsulted.

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“…Almost all studies reveal the previous vaginal birth was found to be a strong predictor [2,3,9]. In our study, 96.4% of women with history of vaginal delivery had successful TOLAC.…”

Section: Discussionsupporting

confidence: 50%

“…A trial of labor after Cesarean (TOLAC) can be a safe alternative and success rates are reported 60-80% [3,[7][8][9][10][11]. Successful TOLAC has many long-and shortterm benefits, including reduced perinatal complications, bleeding, thrombosis, and infection, and later life, chronic pain and ileus [1,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean

Uno

Mayama

Yoshihara

et al. 2020

BMC Pregnancy Childbirth

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“…The larger sample size later in 2014–2015, however, provided a more reliable result. Recent domestic reports showed similar VBAC rate, ranging from 76.7%–87.2% (Li et al, ; Xing et al, ; Yang et al, ). In contrast to the rates reported in a literature review between 60%–77% (Tanos & Toney, ), the relatively higher outcome might be caused by the times of previous C‐S.…”

Section: Discussionmentioning

confidence: 74%

“…The larger sample size later in 2014-2015, however, provided a more reliable result. Recent domestic reports showed similar VBAC rate, ranging from 76.7%-87.2% (Li et al, 2019;Xing et al, 2019;. In contrast to the rates reported in a literature review between 60%-77% (Tanos & Toney, 2019) Our midwifery clinic aims at a caseload model to provide antepartum care for first, second and third trimester so that assessment and guidance can fit in the characteristics of each period.…”

Section: Discussionmentioning

confidence: 96%

Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management

Liu

Zhu

et al. 2019

Journal of Clinical Nursing

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Aims and objectives This research was conducted to explore the effectiveness of employing the healthcare failure mode and effect analysis method in the management of trial of labour after caesarean, with the aims of increasing vaginal birth after caesarean section rate and reducing potential risks that might cause severe complications. Background Previously high caesarean section rate in China and the “two children” policy leads to the situation where multiparas are faced with the choice of another caesarean or trial of labour after caesarean. Despite evidences showing the benefits of vaginal birth after caesarean, obstetricians and midwives in China tend to be conservative due to limited experience and insufficient clinical routines. Thus, its management needs further optimisation in order to make the practice safe and sound. Design A prospective quality improvement programme using the healthcare failure mode and effect analysis. Methods With the structured methodology of healthcare failure mode and effect analysis, we determined core processes of antepartum and intrapartum management, conducted risk priority numbers and devised remedial protocols for failure modes with high risks. The programme was then implemented as a clinical routine under the agreement of the institutional review board and vaginal birth after caesarean success rates were compared before and after the quality improvement programme, both descriptively and statistically. Standards for Quality Improvement Reporting Excellence 2.0 checklist was chosen on reporting the study process. Results Seventy failure modes in seven core processes were identified in the management process, with 14 redressed for actions. The 1‐year follow‐up trial of labour after caesarean and vaginal birth after caesarean rate was increased compared with the previous 3 years, with a vaginal birth after caesarean rate of 86.36%, whereas the incidence of uterine rupture was not compromised. Conclusions The application of healthcare failure mode and effect analysis can not only promote trial of labour after caesarean and vaginal birth after caesarean rate, but also maintaining a low risk of uterine rupture. Relevance to clinical practice This modified vaginal birth after caesarean management protocol has been shown effective in increasing its successful rate, which can be continued for further comparison of severe complications to the previous practice.

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“…The literature also indicated that other strategies are feasible. Li et al's retrospective cohort study demonstrated that trial of labour after caesarean delivery may be a potential strategy for decreasing the CSD rate [80]. This steady decline of CSD, particularly significant among nulliparous and multiparous births without a uterine scar, which is concomitant with a decline in perinatal mortality from 10.1 per 1,000 births to 7.2 per 1,000 births, is the result of institutional interventions and policy change [81].…”

Section: Intercontinental Comparison Of Csd Outcomesmentioning

confidence: 99%

Materno-fetal and neonatal outcomes associated with caesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review

Beogo¹,

Darboue

Marthias

et al. 2020

Preprint

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Background: Advancement in medicine has improved birth assistance. As a result, caesarean section delivery (CSD) has become the most commonly performed surgical procedure. The exponential growth has now skewed toward low-and middle-income countries (LMICs) despite the wellestablished morbimortality risk and extra costs associated to this procedure. The expansion of private healthcare sector may be playing a significant role. The objective of this review synthesizes knowledge and investigates the difference in materno-fetal and neonatal outcomes of CSD in the perinatal period, between private and public hospitals.Methods: Medline, Embase, Cinhal, Cochrane Database, LILACS, and HINARI were screened for peerreviewed published studies in English and French, from 1990 to 2019, in human subjects and supplemented by manual searches. The studies included were prospective and retrospective cohort studies, cross-sectional and Delphi studies comparing perinatal outcomes of women whose neonates were delivered by caesarean section and by vaginal delivery in public and private hospitals. In total, the searches yielded 7,762 studies, assessed independently by two assessors. Of these, 26 quantitative studies were included which risk of bias was considered fairly low.Results: Elective or not, CSD is associated with a variety of outcomes, including death for both the mother and the neonate. Low quality of life, postpartum depression, infections, and scars were burdens attributable to CSD in both sectors. CSD is associated with less urinary incontinence compared to vaginal delivery but no difference exists in early skin-to-skin contact or in early breastfeeding introduction. Finally, across continents, Africa leads in terms of adverse consequences. Discussion/Conclusion: Private facilities surpassed public ones in CSD rate but were associated with the least severe materno-neonatal outcomes. Countries like China are succeeding through robust policies interventions formulation to contain the CSD epidemic and the health issues associated thereto.

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Predicting the success of vaginal birth after caesarean delivery: a retrospective cohort study in China

Cited by 51 publications

References 22 publications

Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean

Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean

Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management

Materno-fetal and neonatal outcomes associated with caesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review

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