Back to “once a caesarean: always a caesarean”? A trend analysis in Switzerland

Christmann-Schmid, Corina; Raio, Luigi; Scheibner, K; Mûller, Martín; Surbek, Daniel

doi:10.1007/s00404-016-4055-4

Cited by 13 publications

(11 citation statements)

References 30 publications

(40 reference statements)

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“…The high success (76 %) of vaginal birth after cesarean section (VBAC) and the degree of maternal and neonatal safety have encouraged physicians and midwives to be supportive of women attempting trial of labor after the previous cesarean section (TOLAC) [3, 4]. Moreover, VBAC is advocated as a means to control the increasing rates of operative delivery [5]. Despite the excellent outcome, every physician should keep in mind the risk of a uterine rupture.…”

Section: Introductionmentioning

confidence: 99%

Tocogram characteristics of uterine rupture: a systematic review

Vlemminx

Lau

Oei

2016

Arch Gynecol Obstet

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PurposeTimely diagnosing a uterine rupture is challenging. Based on the pathophysiology of complete uterine wall separation, changes in uterine activity are expected. The primary objective is to identify tocogram characteristics associated with uterine rupture during trial of labor after cesarean section. The secondary objective is to compare the external tocodynamometer with intrauterine pressure catheters.MethodsMEDLINE, EMBASE, and the Cochrane library were systematically searched for eligible records. Moreover, clinical guidelines were screened. Studies analyzing tocogram characteristics of uterine rupture during trial of labor after cesarean section were appraised and included by two independent reviewers. Due to heterogeneity, a meta-analysis was only feasible for uterine hyperstimulation.ResultsThirteen studies were included. Three tocogram characteristics were associated with uterine rupture. (1) Hyperstimulation was more frequently observed compared with controls during the delivery (38 versus 21 % and 58 versus 53 %), and in the last 2 h prior to birth (19 versus 4 %). Results of meta-analysis: OR 1.68 (95 % CI 0.97–2.89), p = 0.06. (2) Decrease of uterine activity was observed in 14–40 % and (3) an increasing baseline in 10–20 %. Five studies documented no changes in uterine activity or Montevideo units. A direct comparison between external tocodynamometer and intrauterine pressure catheters was not feasible.ConclusionsUterine rupture can be preceded or accompanied by several types of changes in uterine contractility, including hyperstimulation, reduced number of contractions, and increased or reduced baseline of the uterine tonus. While no typical pattern has been repeatedly reported, close follow-up of uterine contractility is advised and hyperstimulation should be prevented.

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Section: Introductionmentioning

confidence: 99%

Tocogram characteristics of uterine rupture: a systematic review

Vlemminx

Lau

Oei

2016

Arch Gynecol Obstet

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“…2,3 Occasional uterine rupture and fetal risks have changed the outlook for trial of labour after previous caesarean section. 4,5 Vaginal birth after cesarean (VBAC) has reduced in frequency over last 10 years. [4][5][6] Elective repeat caesarean sections contribute in large proportion to the caesarean section rates.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Vaginal birth after cesarean (VBAC) has reduced in frequency over last 10 years. [4][5][6] Elective repeat caesarean sections contribute in large proportion to the caesarean section rates. Gradually caesarean section rates are increasing in frequency.…”

Section: Introductionmentioning

confidence: 99%

Analysis of success of vaginal birth after cesarean in relation to indication of primary caesarean section: a tertiary care experience

Gupta

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Apprehensions related to vaginal birth after caesarean (VBAC) has reduced rates of successful vaginal trials over last decade. The objective of this study was to identify the indications of first caesarean section that can lead to a successful trial of labour in subsequent pregnancy.Methods: Retrospective cohort study was done between November 2014 and October 2017. Data from the case records was analysed.Results: Study over 3 years from 2014 to 2017 revealed fetal distress (82.7%), breech (72.2%), transverse lie (66.7%), antepartum haemorrhage (56.2%) and twins with first non-cephalic (57.9%) have successful outcome of VBAC whereas obstructed labour (19.2%) and failed induction (18.4%) in previous pregnancy have poor outcome for VBAC.Conclusions: Attempts to allow trial of labour after one previous caesarean section with fetal distress, malpresentation and twins as indications of caesarean in previous pregnancy are safe and should be encouraged.

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“…But considering the benefits of normal delivery, experts permit natural childbirth to individuals who have a history of cesarean section and who do not have = contraindications for vaginal delivery. and study these groups (17,18).…”

Section: Introductionmentioning

confidence: 99%