Vaginal birth after caesarean section versus elective repeat caesarean section: assess neonatal downstream outcomes too

Abstract

Vaginal birth after caesarean section versus elective repeat caesarean section: assess neonatal downstream outcomes too Sir, We were interested in the article by Pare et al. 1 showing an excess increase in hysterectomy in subsequent pregnancies for women having elective repeat caesarean sections. Further valuable information is added to the risk assessment which women, obstetricians and midwives must make; both when considering a primary caesarean section or waiting for labour in a subsequent pregnancy. The National Institute of Clinical Excellence has examined the health risks of caesarean section and concluded that, even for a first caesarean section, maternal request alone is not an indication for elective major surgery and requires the use of counselling to explore women's motives and a second opinion, 2 because of the imbalance of health risks to mothers and babies which only widens with increasing parity and increasing numbers of caesarean sections. It is generally better to labour 852 ª

Prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia: A systematic review and meta-analysis

“…Also, a total of 385 unrelated papers were excluded after titles and abstracts were reviewed. Then, twenty-two ( 18 ) papers were retrieved for detailed examination, and after a full-text review of those papers, ten ( 10 ) papers were excluded due to different populations and outcomes of interest not reported. Finally, full texts of the remaining twelve ( 12 ) papers were selected for the methodological quality assessment using JBI critical appraisal tools.…”

“…Although operative vaginal deliveries involves a risk for maternal and neonatal complications ( 10 , 11 ), many women prefer OVDs than caesarian section due to longer recovery and downstream health effects associated with cesarean section ( 1 , 12 ). Both forceps and vacuum have the potential to cause maternal and neonatal injury; however, the incidence of maternal injury is more with the forceps than with vacuum.…”

Authors response to: Vaginal birth after caesarean section versus elective repeat caesarean section: assess neonatal downstream outcomes too

“…We thank Ms Cohain and Dr Bewley for their interest in our work. 1 We agree that strategies to ultimately decrease the number of women undergoing multiple repeat caesarean sections should include to safely limit the rate of primary caesarean section. However, we disagree with their interpretation of our findings that vaginal birth after caesarean section (VBAC) may be overall safer in birth centres than in hospitals.…”

“…We thank Ms Cohain and Dr Bewley for their interest in our work 1 . We agree that strategies to ultimately decrease the number of women undergoing multiple repeat caesarean sections should include to safely limit the rate of primary caesarean section.…”