Document Detail

Maternal morbidity following a trial of labor after cesarean section vs elective repeat cesarean delivery: a systematic review with metaanalysis.
MedLine Citation:
PMID:  18511018     Owner:  NLM     Status:  MEDLINE    
This study reviewed maternal morbidity following trial of labor (TOL) after cesarean section, compared with elective repeat cesarean delivery (ERCS). Articles were pooled to compare women planning vaginal birth after cesarean (VBAC) with those undergoing ERCS with regard to maternal morbidity (MM), uterine rupture/dehiscence (UR/D), blood transfusion (BT), and hysterectomy. The former group was subdivided into successful VBAC (S-VBAC) and failed TOL (F-TOL). VBAC was successful in 17,905 of 24,349 patients (73%). MM, BT, and hysterectomy were similar in women planning VBAC or ERCS, whereas UR/D was different (1.3%; 0,4%). MM, UR/D, BT and hysterectomy were more common after F-TOL (17%, 4.4%, 3%; 0.5%) than after S-VBAC (3.1%, 0.2%, 1.1%; 0.1%) or ERCS (4.3%, 0.4%, 1%; 0.3%). Outcomes were more favorable in S-VBAC than ERCS. These findings show that a higher risk of UR/D in women planning VBAC than ERCS is counterbalanced by reduction of MM, UR/D. and hysterectomy when VBAC is successful.
A Cristina Rossi; Vincenzo D'Addario
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review     Date:  2008-06-03
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  199     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-05     Completed Date:  2008-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  224-31     Citation Subset:  AIM; IM    
IV Clinic of Obstetrics and Gynecology, University of Bari, Bari, Italy.
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MeSH Terms
Cesarean Section*
Cesarean Section, Repeat
Risk Factors
Surgical Procedures, Elective
Surgical Wound Dehiscence / epidemiology
Trial of Labor*
Uterine Rupture / epidemiology
Vaginal Birth after Cesarean* / adverse effects

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