Trial of labor in patients with a previous lower uterine vertical cesarean section

Adair, Charles; Sánchez-Ramos, Luis; Whitaker, Donald; McDyer, Daniel; Farah, Lisa; Briones, Donna

doi:10.1016/s0002-9378(96)70334-4

Cited by 38 publications

(7 citation statements)

References 9 publications

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“…Successful trial of vaginal birth was observed in 57(59.4%) women, which was lower than the rates reported from studies conducted in Europe and US 8,9 which were 75% and 61.4% respectively. The reported success rates of a study done in Karachi was 62% 10 , however a recent study done in Nawabshah reported a success rate of 41.93% which is much lower than our study.…”

Section: Discussioncontrasting

confidence: 67%

Maternal Weight; Impact on Success of Vaginal Birth After Cesarean Section

Zahiruddin

Malhi

Jabeen

et al. 2017

TPMJ

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Impact of maternal weight on success of VBAC. Introduction: Worldwide Cesarean section is the commonest obstetrical procedure to be performed and same situation is in Pakistan. One strategy is to offer vaginal birth after cesarean section to reduce the alarming cesarean rate. Many factors have been Identified which can affect success of trial of labor. Maternal weight has an important relation with the reproductive health of women, as obesity during pregnancy is associated with increased maternal and fetal risk. Maternal obesity has been shown to be associated with increased rates of primary cesarean delivery and failed trial of vaginal birth after cesarean delivery. Objectives: To determine the effect of maternal weight on success of VBAC. Study Design: Cross sectional study. Period: May 2012 to October 2013. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilled the selection criteria were included in the study. Results: The women included in the study had a mean age of SD (range), 29.94+ 4.41 (20-40 years) successful vaginal births was observed in 57(59.4%) women and 39(40.6%) had an emergency repeat cesarean delivery. Body mass index was noted among all the women, 23(24.0%) were obese and 73 (76.0%) were non-obese. Out of 23(24.0), 7(30.4%) had successful VBAC and 16(69.6%) women had successful trial of labor and 23(31.5%) delivered by repeat Caesarean delivery. (P.0.002) P value = 0.001 is statistically significant and calculated by Fisher's exact X 2 test. Conclusions: Obesity is associated with decreased chances of successful VBAC, making it a risky option for obese women.

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Section: Discussioncontrasting

confidence: 67%

Maternal Weight; Impact on Success of Vaginal Birth After Cesarean Section

Zahiruddin

Malhi

Jabeen

et al. 2017

TPMJ

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“…First, women with “nonclassic” cesarean deliveries were included in their analysis, which may be a more heterogeneous population than ours since this exposure definition includes nontransverse uterine incisions. Although low vertical incisions do not appear to carry a higher risk of maternal morbidity, 9–11 inverse T incisions extend into the fundus of the uterus and carry maternal risks similar to that of a classical cesarean. 12 Second, while Sciscione et al 6 defined the exposure as a prior cesarean before 37 weeks, we chose to define the exposure as a prior cesarean at or before 34 weeks, as the lower uterine segment is likely developed or developing at 34 weeks.…”

Section: Commentmentioning

confidence: 99%

Effect of gestational age at the prior cesarean delivery on maternal morbidity in subsequent VBAC attempt

Cahill¹,

Stamilio²,

Odibo³

et al. 2009

American Journal of Obstetrics and Gynecology

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OBJECTIVE The purpose of this study was to estimate the effect of gestational age at the time of prior cesarean on maternal morbidity in women attempting vaginal birth after cesarean delivery (VBAC). STUDY DESIGN A retrospective cohort study of women attempting VBAC, comparing women with a prior cesarean delivery ≥ 34 completed weeks to women with a prior cesarean delivery > 34 weeks. The primary outcome was maternal morbidity, including uterine rupture. Univariable, stratified, and multivariable analyses were used to estimate the effect of a prior cesarean performed at ≤ 34 weeks on maternal morbidities. RESULTS Of 19,474 women with 1 prior cesarean, 12,535 attempted VBAC and 508 of those had a previous cesarean ≤ 34 weeks. Study groups had similar risks of uterine rupture (adjusted OR [AOR], 1.5; 95% CI, 0.7–3.5; P = .32) and composite morbidity (AOR, 0.9; 95% CI, 0.5–1.8; P = .81). CONCLUSION Prior cesarean delivery at ≤ 34 weeks’ gestation does not appear to increase the risk of maternal morbidity in a subsequent VBAC attempt.

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“…18,19 In contrast, a low-vertical CD which remains in the lower uterine segment would not be expected to increase the UR risk, and in fact this is supported by several studies. [20][21][22] It is not clear whether a prior double-layer hysterotomy incision closure is protective against UR with TOLAC, [23][24][25] and risk may in fact be more related to the type of suture used (ie, chromic catgut or polyglactin). 23 Interpregnancy intervals of either less than 6 months 26 or 2 years 27 are associated with greater UR risk likely secondary to suboptimal healing and smooth muscle regeneration by the time VBAC is attempted.…”

Section: Vbacmentioning

confidence: 99%

Uterine Rupture as a Source of Obstetrical Hemorrhage

Landon

2010

Clinical Obstetrics &Amp; Gynecology

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Uterine rupture is an important cause of obstetrical hemorrhage associated with morbidity for mother and fetus. Risk factors should be discussed in the counseling process. Intrapartum findings including maternal condition, fetal heart rate monitoring, and uterine activity may prove helpful in making the diagnosis of a dehiscence or rupture, but ultimately this requires some degree of suspicion by the labor and delivery team. As in any case of acute obstetrical emergency, preparation and timely mobilization of all necessary personnel is key to optimizing outcome.

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Trial of labor in patients with a previous lower uterine vertical cesarean section

Cited by 38 publications

References 9 publications

Maternal Weight; Impact on Success of Vaginal Birth After Cesarean Section

Maternal Weight; Impact on Success of Vaginal Birth After Cesarean Section

Effect of gestational age at the prior cesarean delivery on maternal morbidity in subsequent VBAC attempt

Uterine Rupture as a Source of Obstetrical Hemorrhage

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