Vaginal Delivery After Previous Caesarean Section for Failure of Second Stage of Labour

Adverse Obstetric Outcomes in Women with Previous Cesarean for Dystocia in Second Stage of Labor

“…1,14 Our findings are in agreement with those of Jongen et al, who found that a previous cesarean for dystocia in the second stage was associated with 80% of successful TOL but with higher rates of operative vaginal delivery (48%). 17 Bujold and Gauthier showed similar rates of vaginal delivery in women with previous cesarean for dystocia in the second stage compared with other indications for previous cesarean, but they demonstrated greater risks of second-stage dystocia and operative vaginal delivery in this subgroup. 16 In contrast, Hoskins and Gomez found a very low rate of successful TOL in these women.…”

“…16,17 Prior studies did not focus on the risk of uterine rupture in this subgroup of women. Because labor dystocia and fetal macrosomia are two risk factors for uterine rupture, we hypothesized that these women could be at higher risk for uterine rupture in the second stage of labor, especially in cases of fetal macrosomia.…”

Trial of labor after cesarean

“…Nevertheless, about 60% to 70% of women undergoing a TOLAC for dystocia (failure to progress) deliver vaginally (1). In addition, most studies show no reduction in the rates for a successful TOLAC after a prior CD done for failure to progress in the second stage of labor (75-80%), with no increased risk of operative vaginal delivery (1,25,26).…”

Vaginal delivery after previous caesarean section for failure of second stage of labour

“…I read with interest the paper by Jongen et al (Vol 105, October 1998) 1 that addresses a difficult obstetric problem. They conclude that for women during their first delivery, in whom the fetus had a cephalic presentation with an arrest of descent in the second stage of labour, the chances of a vaginal delivery in their next pregnancy are high.…”

“…Although there was an 80% vaginal delivery rate reported, one has to recognise that overall only 40/103 (39%) of the women achieved a spontaneous vaginal delivery, or to state the converse, 63/103 women in this selected group required a Caesarean section or instrumental vaginal delivery. Women with prolonged or dysfunctional labour at the first birth are less likely to attempt a subsequent vaginal delivery, perhaps because of the memory of a long, painful and unsuccessful first labou 1 . If aware of the fact that there is a less than 50% chance of a successful spontaneous vaginal delivery, I would suggest that many women would choose to have an elective caesarean section and therefore it is inappropriate to conclude that a trial of labour can usually be undertaken.…”