Document Detail

Trial of labor after one cesarean: role of the order and number of prior vaginal births on the risk of emergency cesarean delivery and neonatal admission.
MedLine Citation:
PMID:  18935994     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the influences of mode of immediate preceding delivery and number of prior vaginal births on the risk of repeat cesarean and neonatal admission at attempted vaginal birth after cesarean. MATERIALS AND METHODS: We performed a retrospective study of the risk factors for emergency repeat cesarean delivery and neonatal admission in a trial of labor after prior cesarean section. The study comprised 342 women at term with at least one prior vaginal delivery in addition to one previous lower transverse cesarean. Clinical variables with crude p < 0.2 on Fisher's exact test for the defined primary outcomes of repeat cesarean and neonatal admission were included in the model for multivariable logistic regression analysis. RESULTS: Cesarean as the immediate preceding mode of delivery (adjusted odds ratio, 5.3; 95% confidence interval, 2.5-10.8) was an independent predictor of emergency repeat cesarean delivery but not of neonatal admission. Higher parity of two or more previous vaginal deliveries compared with only one prior vaginal delivery was not associated with repeat cesarean or neonatal admission. CONCLUSION: In women who have had prior vaginal birth attempting a trial of labor after cesarean, a vaginal delivery before cesarean delivery is an independent risk factor for repeat cesarean. Women with two or more prior vaginal births have a similar risk for repeat cesarean and neonatal admission to women with only one prior vaginal birth.
Peng Chiong Tan; Revathy Nadesan Subramaniam; Siti Zawiah Omar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Taiwanese journal of obstetrics & gynecology     Volume:  47     ISSN:  1875-6263     ISO Abbreviation:  -     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2009-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213819     Medline TA:  Taiwan J Obstet Gynecol     Country:  China    
Other Details:
Languages:  eng     Pagination:  305-11     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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MeSH Terms
Cesarean Section / statistics & numerical data
Cesarean Section, Repeat / adverse effects,  statistics & numerical data*
Cohort Studies
Confidence Intervals
Emergency Treatment
Follow-Up Studies
Gestational Age
Infant, Newborn
Odds Ratio
Prenatal Care / methods
Retrospective Studies
Risk Assessment
Treatment Outcome
Trial of Labor*
Vaginal Birth after Cesarean / adverse effects*,  statistics & numerical data*

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

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