Document Detail

The effect of prematurity on vaginal birth after cesarean delivery: success and maternal morbidity.
MedLine Citation:
PMID:  15738018     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that preterm women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC. METHODS: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals. We collected information on demographics, medical and obstetric history, complications, and outcome of the index pregnancy. The primary analysis was limited to women with singleton gestations and one prior cesarean delivery. Statistical analysis consisted of bivariate and multivariable techniques. RESULTS: Among the 20,156 patients with one prior cesarean delivery, 12,463 (61%) attempted a VBAC. Mean gestational ages for the term and preterm women were 39.2 weeks and 33.9 weeks of gestation, respectively. The VBAC success rates for the term and preterm groups were 74% and 82%, respectively (P < .001). Multivariable analysis showed that the VBAC success was higher (adjusted odds ratio 1.54, 95% confidence interval 1.27-1.86) in preterm gestations. A decreased risk of rupture among preterm gestations was suggested in these results (adjusted odds ratio 0.28, 95% confidence interval 0.07-1.17; P = .08). CONCLUSION: Preterm patients undergoing a VBAC have higher success rates when compared with term patients undergoing a VBAC. Preterm patients undergoing VBAC may have lower uterine rupture rates.
Joanne N Quiñones; David M Stamilio; Emmanuelle Paré; Jeffrey F Peipert; Erika Stevens; George A Macones
Related Documents :
16875648 - The mfmu cesarean registry: impact of time of day on cesarean complications.
24818008 - Vitamin d/dietary calcium deficiency rickets and pseudo-vitamin d deficiency rickets.
2304708 - The cesarean delivery rate can be safely reduced in a developing country.
14504078 - Confirmation of the molecular classification of diffuse large b-cell lymphoma by immuno...
11150828 - Elevated type iv collagen in bronchoalveolar lavage fluid from infants with bronchopulm...
263368 - A review of autopsies at the university teaching hospital, lusaka, 1975.
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  105     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-01     Completed Date:  2005-04-07     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  519-24     Citation Subset:  AIM; IM    
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cesarean Section, Repeat / adverse effects
Gestational Age
Obstetric Labor, Premature*
Pregnancy Complications
Risk Factors
Uterine Rupture / etiology
Vaginal Birth after Cesarean* / adverse effects
Grant Support
K24 HD 01289/HD/NICHD NIH HHS; K24 HD 01298/HD/NICHD NIH HHS; R01 H035631//PHS HHS; T32 HD 07440-07/HD/NICHD NIH HHS

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

Previous Document:  Novel modification of the vertical rectus abdominis myocutaneous flap for neovagina creation.
Next Document:  The impact of vaginal delivery in premature infants weighing less than 1,251 grams.