Document Detail

Outcome of subsequent pregnancy three years after previous operative delivery in the second stage of labour: cohort study.
MedLine Citation:
PMID:  14724128     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the reproductive outcome and the mode of delivery in subsequent pregnancies after instrumental vaginal delivery in theatre or caesarean section at full dilatation.
DESIGN: Prospective cohort study.
SETTING: Two urban hospitals with a combined total of 10 000 deliveries a year.
PARTICIPANTS: A cohort of 393 women with term, singleton, cephalic pregnancies who needed operative delivery in theatre during the second stage of labour from February 1999 to February 2000. Postal questionnaires were received from 283 women (72%) at three years after the initial delivery.
MAIN OUTCOME MEASURE: Mode of delivery in the subsequent pregnancy.
RESULTS: 140 women (49%) achieved a further pregnancy at three years. 91/283 (32%) women wished to avoid a further pregnancy. Women were more likely to aim for vaginal delivery (87% (47/54) v 33% (18/54); adjusted odds ratio 15.55 (95% confidence interval 5.25 to 46.04)) and more likely to have a vaginal delivery (78% (42/54) v 31% (17/54); 9.50 (3.48 to 25.97)) if they had had a previous instrumental vaginal delivery rather than a caesarean section. There was a high rate of vaginal delivery after caesarean section among women who attempted vaginal delivery 17/18 (94%). In both groups, fear of childbirth was a frequently reported reason for avoiding a further pregnancy (51% after instrumental vaginal delivery, 42% after caesarean section; 1.75 (0.58 to 5.25)).
CONCLUSION: Instrumental vaginal delivery offers advantages over caesarean section for future delivery outcomes. The psychological impact of operative delivery requires urgent attention.
Rachna Bahl; Bryony Strachan; Deirdre J Murphy
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2004-01-14
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  328     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-06     Completed Date:  2004-03-02     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  311     Citation Subset:  AIM; IM    
St Michael's Hospital, Bristol BS2 8EG.
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MeSH Terms
Cesarean Section / statistics & numerical data
Cohort Studies
Delivery, Obstetric / statistics & numerical data*
Infertility, Female / etiology
Labor Stage, Second
Obstetric Labor Complications / surgery*
Pregnancy / statistics & numerical data*
Pregnancy Outcome
Prospective Studies
Time Factors
Vaginal Birth after Cesarean / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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