Comparison of maternal-neonatal results of vaginal birth after cesarean  and elective repeat cesarean delivery

İzbudak, Gizem; Tozkir, Elif; Çöğendez, Ebru; Uzun, Faik; Eser, S

doi:10.5603/gp.a2020.0132

Cited by 7 publications

(11 citation statements)

References 21 publications

(23 reference statements)

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“…Previous studies had shown a positive correlation between perineal lacerations and operative vaginal deliveries, but most of these studies concentrated on third-and fourth-degree perineal tears [2,9,18,20]. Our study included perineal lacerations from rst-to fourth-degree, and the result was consistent with the observation reported elsewhere, [9] showing a higher risk of spontaneous perineal tears in VBAC women and VBAC women without cervical dilation compared to the primipara control group.…”

Section: Maternal and Neonatal Outcomes Of The Study Groupssupporting

confidence: 86%

Labor Characteristics And Intrapartum Interventions In Women With Vaginal Birth After Cesarean Section

Lan

Pan

Peng

et al. 2022

Preprint

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Background: Cesarean delivery is the most frequently performed surgical procedure worldwide. With the development of China’s Two-child-policy, vaginal birth after cesarean section (VBAC) has aroused a great public concern due to the fear of perinatal complications and uterine rupture. It is important to understand the labour characteristics and intrapartum management of women attempting VBAC to enhance the rates of successful VBAC. In this study, we aimed to provide clinical evidence of standardized intrapartum management in women with a trial of labour after cesarean section (TOLAC).Material and methods: This observational retrospective study enrolled all VBAC women who delivered vaginally with spontaneous labor at the Second Affiliated Hospital of Wenzhou Medical University from 2016 and 2019. They were allocated into observation A group (the previous cesarean section was performed before dilation of cervix) and observation B group (the previous cesarean section was performed after dilation of cervix). 149 primiparae constituted primipara control group and 155 multiparae with second vaginal birth constituted multipara control group. Durations of labor, intervention measures and perinatal outcomes were compared among the groups.Results: The durations of labor, intrapartum interventions and maternal and neonatal outcomes in observation A group resembled to observation B group. However, compared with primiparae, women in observation group and observation A group had shorter first, second and the total stages of labor. Compared with multiparae, Women in observation group and observation B group had longer second stage of labor, but shorter third stage of labor. VBAC women were more likely to receive episiotomy and had higher incidences of postpartum hemorrhage than primipara and multipara women.Conclusions: Labour characteristics in VBAC women with or without cervix dilation showed no significant difference, but differed significantly from those of multiparae and primiparae. Artificial rupture of membrane, oxytocin, phloroglucinol and epidural analgesia is regularly used for VBAC women. Episiotomy is encouraged to shorten the second stage of labor, while forceps delivery should be minimized whenever possible. We should be alert to the occurrence of postpartum hemorrhage in VBAC women.

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Section: Maternal and Neonatal Outcomes Of The Study Groupssupporting

confidence: 86%

Labor Characteristics And Intrapartum Interventions In Women With Vaginal Birth After Cesarean Section

Lan

Pan

Peng

et al. 2022

Preprint

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“…In a recent study by İzbudak 2021, [ 35 ] it was observed that certain factors have an impact on the success of TOLAC including maternal age, birth weight, the number of previous vaginal deliveries, and the presence of spontaneous onset of active-phase labor. Additionally, maternal pelvis and fetal size were found to be significant factors associated with TOLAC success.…”

Section: Discussionmentioning

confidence: 99%

“…After a thorough assessment of the remaining 13 studies, they were included in the final analysis. [21,[27][28][29][30][31][32][33][34][35][36][37][38] Figure 1 described the detailed search process.…”

Section: Study Selectionmentioning

confidence: 99%

The impact of a trial of labor after cesarean versus elective repeat cesarean delivery: A meta-analysis

Chen,

2024

Medicine

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Background: The increasing global incidence of cesarean section has prompted efforts to reduce cesarean delivery rates. A trial of labor after cesarean (TOLAC) has emerged as an alternative to elective repeat cesarean delivery (ERCD) for women with a prior cesarean delivery. However, the available evidence on the comparative outcomes of these 2 options remains inconsistent, primarily due to varying advantages and risks associated with each. Our meta-analysis aims to compare the maternal-neonatal results in TOLAC and ERCD in women with prior cesarean deliveries. Methods: A comprehensive search was performed in PubMed, Embase, Cochrane library databases up to September,2022 to identity studies evaluating perinatal outcomes in women who underwent TOLAC compared to ERCD following a previous cesarean delivery. The included studies were subjected to meta-analysis using RevMan 5.3 software to assess the overall findings. Results: A total of 13 articles were included in this meta-analysis. Statistically significant differences were identified in the rate of uterine rupture (OR = 2.01,95%CI = 1.48–2.74, P < .00001) and APGAR score < 7 at 5 minutes (OR = 2.17,95%CI = 1.69–2.77, P < .00001) between the TOLAC and ERCD groups. However, no significant differences were observed in the rates of hysterectomy, maternal blood transfusion, postpartum infection, postpartum hemorrhage and neonatal intensive care unit (P ≥ .05) admission between the 2 groups. Conclusions: Our analysis revealed that TOLAC is associated with a higher risk of uterine rupture and lower incidence APGAR score < 7 at 5 minutes compared to ERCD. It is vital to consider predictive factors when determining the appropriate mode of delivery in order to ensure optimal pregnancy outcomes. Efforts should be made to identify the underlying causes of adverse outcomes and implement safety precautions to select suitable participants and create safe environments for TOLAC.

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“…Previous studies had shown a positive correlation between perineal lacerations and assisted vaginal birth, but most of these studies concentrated on third- and fourth-degree perineal tears [ 3 , 11 , 20 , 21 ]. Our study included perineal lacerations from first- to fourth-degree, and the result was consistent with the observation reported elsewhere [ 11 ], showing a higher risk of spontaneous perineal tears in women who had a VBAC, especially in those without cervical dilation when compared to the primipara control group.…”

Section: Discussionmentioning

confidence: 99%

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

Lan

Pan

Chen

et al. 2022

BMC Pregnancy Childbirth

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Background With the development of China’s two-child-policy, vaginal birth after cesarean section (VBAC) has aroused public concern. It is important to understand the labour characteristics and intrapartum management of women attempting VBAC to enhance the rates of successful VBAC. The purpose of our research was to investigate the differences in the characteristics of labor, intervention measures and perinatal outcomes between women who had a VBAC and primiparas or multiparas not undergoing VBAC, providing clinical references of intrapartum management for women who are planning a VBAC. Material and methods This observational retrospective study enrolled all women who laboured spontaneously and who had a VBAC (n = 139) at the Second Affiliated Hospital of Wenzhou Medical University in China between 2016 and 2019. They were allocated into VBAC group A (the previous cesarean section was performed before dilation of the cervix) and VBAC group B (the previous cesarean section was performed after dilation of the cervix). The primipara control group included 149 primiparae, and the multipara control group included 155 multiparae with second vaginal birth. Durations of labor, intervention measures and perinatal outcomes were compared among the groups. Results The durations of labor, intrapartum interventions and maternal and neonatal outcomes in VBAC group A were similar to those of the VBAC group B. However, all women who had a VBAC and those in VBAC group A had shorter first, second and the total stages of labor than primiparae. All women with VBAC and those in VBAC group B had longer second stage of labor, but shorter third stage of labor than multiparae. Oxytocin, labor analgesia and artificial rupture of membranes were administered less often in women with VBAC than in primiparae, while phloroglucinol was administered more often in women with VBAC than in multiparae. Women who had a VBAC were more likely to receive episiotomy and had higher incidences of postpartum hemorrhage than primipara and multipara women. Conclusions Labor characteristics, intrapartum interventions and perinatal outcomes in women who had a VBAC with cervical dilation were similar to those in women who had a VBAC without cervical dilation before the previous cesarean section, but differed significantly from those of multiparae and primiparae who did not undergo VBAC.

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Comparison of maternal-neonatal results of vaginal birth after cesarean and elective repeat cesarean delivery

Cited by 7 publications

References 21 publications

Labor Characteristics And Intrapartum Interventions In Women With Vaginal Birth After Cesarean Section

Labor Characteristics And Intrapartum Interventions In Women With Vaginal Birth After Cesarean Section

The impact of a trial of labor after cesarean versus elective repeat cesarean delivery: A meta-analysis

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

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