Perinatal outcomes after successful and failed trials of labor after cesarean delivery

Yasser Y. El-Sayed, Melanie M. Watkins, Megan Fix, Maurice L. Druzin, Kristin M. Pullen, Aaron B. Caughey

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective: To compare maternal and neonatal outcomes after successful and failed trials of labor after cesarean in women at term, excluding uterine ruptures, and to examine predictors of successful and failed trials of labor. Study Design: Matched maternal and neonatal data from 1993-1999 in women with singleton term pregnancies with prior cesarean undergoing trial of labor were reviewed. Women with uterine rupture were excluded. Maternal and neonatal outcomes were analyzed for successful and failed trials. Predictors of success and failure were examined. Results: 1284 women and their neonates were available for analysis. 1094 (85.2%) had a vaginal birth and 190 (14.8%) underwent repeat cesarean. Failed trials of labor were associated with higher incidence of choriamnionitis (25.8% vs. 5.5%, P<.001), postpartum hemorrhage (35.8% vs. 15.8%, P<.001), hysterectomy (1% vs. 0%, P=.022), neonatal jaundice (17.4% vs.10.2%, P=.004) and composite major neonatal morbidities (6.3% vs. 2.8%, P=.014). Conclusion: Failed trial of labor in women at term with prior cesarean is associated with increased maternal and neonatal morbidities.

Original languageEnglish (US)
Pages (from-to)583.e1-583.e5
JournalAmerican journal of obstetrics and gynecology
Volume196
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Keywords

  • VBAC
  • perinatal outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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