Document Detail

Spontaneous versus induced labor after a previous cesarean delivery.
MedLine Citation:
PMID:  12850605     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare maternal and neonatal outcomes in spontaneous versus induced labor after one previous cesarean delivery. METHODS: Women with one previous cesarean delivery who had spontaneous labor between January 1992 and January 2000 were compared with those whose labor was induced. RESULTS: Three thousand seven hundred forty-six patients had a trial of labor (2943 spontaneous, 803 induced). Those induced had more frequent early postpartum hemorrhage (7.3% versus 5.0%; odds ratio [OR] 1.66; 95% confidence interval [CI] 1.18, 2.32), cesarean delivery (37.5% versus 24.2%; OR 1.84; 95% CI 1.51, 2.25), and neonatal intensive care unit (NICU) admission (13.3% versus 9.4%; OR 1.69; 95% CI 1.25, 2.29). There was a trend toward higher uterine rupture rates in those with induced versus spontaneous labor (0.7% versus 0.3%, P =.128) and for patients undergoing dinoprostone (prostaglandin E(2)) induction versus other methods (1.1% versus 0.6%, P =.62), although neither difference achieved statistical significance. CONCLUSION: Induced labor is associated with an increased rate of early postpartum hemorrhage, cesarean delivery, and neonatal ICU admission. The higher rate of uterine rupture in those who had labor induced was not statistically significant.
Tina Delaney; David C Young
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-44     Citation Subset:  AIM; IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Case-Control Studies
Cesarean Section / statistics & numerical data
Cohort Studies
Dinoprostone / therapeutic use
Follow-Up Studies
Gestational Age
Infant Mortality / trends*
Infant, Newborn
Labor, Induced / methods*,  mortality
Maternal Mortality / trends*
Obstetric Labor Complications / mortality
Oxytocics / therapeutic use
Reference Values
Risk Factors
Uterine Rupture / etiology,  mortality
Vaginal Birth after Cesarean / methods*,  mortality
Reg. No./Substance:
0/Oxytocics; 363-24-6/Dinoprostone

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

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