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Elammary MN, Zohiry M, Sayed A, Atef F, Ali N, Hussein I, Mahran MA, Said AE, Elassall GM, Radwan AA, Shazly SA. Middle eastern college of obstetricians and gynecologists (MCOG) practice guidelines: Role of prediction models in management of trial of labor after cesarean section. Practice guideline no. 05-O-22 ✰,✰✰,★,★★. J Gynecol Obstet Hum Reprod 2023; 52:102598. [PMID: 37087045 DOI: 10.1016/j.jogoh.2023.102598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 04/24/2023]
Abstract
Cesarean delivery rates have been steadily rising since the beginning of the 21st century. The growing incidence is even more prominent in developing countries owing to lack of evidence-based guidance and audit, and the expansion of private practice. The uprise in Cesarean delivery rate has been associated with considerable financial burden and has increased the risk otherwise uncommon serious complications such as placenta accreta disorders and uterine rupture. In addition to primary prevention of Cesarean delivery, trial of labor after cesarean section is one of the most successful strategies to reduce Cesarean deliveries and minimize risks associated with higher order Cesarean deliveries. This guideline appraises patient selection strategies and use of prediction model to promote counseling and enhance safety in women considering vaginal birth after Cesarean.
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Affiliation(s)
| | - Mariam Zohiry
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Asmaa Sayed
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Fatma Atef
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Nada Ali
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Islam Hussein
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Manar A Mahran
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Aliaa E Said
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Gena M Elassall
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Ahmad A Radwan
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom
| | - Sherif A Shazly
- Middle Eastern College of Obstetricians and Gynecologists (MCOG) Practice Office. Leeds, United Kingdom; Department of Obstetrics and Gynecology, Leeds Teaching Hospitals, Leeds, United Kingdom.
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Abstract
OBJECTIVE To provide evidence-based guidelines for the provision of a trial of labour after Caesarean section. OUTCOMES Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean and repeat Caesarean section. EVIDENCE MEDLINE database was searched for articles published from January 1, 1995, to October 31, 2017 using the key words "vaginal birth after Caesarean (Cesarean) section." The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam. VALIDATION These guidelines were approved by the Clinical Practice Obstetrics Committee and the Board of the Society of Obstetricians and Gynaecologists of Canada. RECOMMENDATIONS
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Martel MJ, MacKinnon CJ. No. 155-Guidelines for Vaginal Birth After Previous Caesarean Birth. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019. [PMID: 29525045 DOI: 10.1016/j.jogc.2018.01.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To provide evidence-based guidelines for the provision of a trial of labour (TOL) after Caesarean section. OUTCOME Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean (VBAC) and repeat Caesarean section. EVIDENCE MEDLINE database was searched for articles published from January 1, 1995, to February 28, 2004, using the key words "vaginal birth after Caesarean (Cesarean) section." The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam. RECOMMENDATIONS VALIDATION: These guidelines were approved by the Clinical Practice Obstetrics and Executive Committees of the Society of Obstetricians and Gynaecologists of Canada.
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Dy J, DeMeester S, Lipworth H, Barrett J. N o 382 - Épreuve de travail après césarienne. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:1012-1034. [PMID: 31227056 DOI: 10.1016/j.jogc.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Satpathy G, Kumar I, Matah M, Verma A. Comparative accuracy of magnetic resonance morphometry and sonography in assessment of post-cesarean uterine scar. Indian J Radiol Imaging 2018; 28:169-174. [PMID: 30050239 PMCID: PMC6038215 DOI: 10.4103/ijri.ijri_325_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective To compare the diagnostic accuracy of magnetic resonance imaging (MRI) with that of ultrasonography (USG) for the measurement of lower segment cesarean scar during trial of labor after cesarean (TOLAC). Materials and Methods This was a prospective case-control observational study conducted with a cohort of 30 participants being considered for TOLAC but eventually proceeding to lower segment cesarean section (LSCS) at a university-based teaching institute over a period of 2 years. Measurement of scar thicknesses were done by MRI and USG preoperatively and validated by surgical findings. Comparison of diagnostic accuracy as well as the cut-off values (to differentiate a normal scar from an abnormal scar) was done between the two modalities. Results Insignificant systematic error between the measurements obtained by the two modalities was noted by a Bland-Altmann analysis. The diagnostic accuracy of USG for differentiating a normal from an abnormal uterine scar was 96.7% while that of MRI was at a slightly lower level of 90%. A strong level of agreement between the two modalities was observed. Conclusion MRI offers no advantage in diagnostic accuracy for the measurement of LSCS scar thickness during consideration of TOLAC. Advances in Knowledge Measurement of uterine scar by MRI has a good correlation with that done on USG in the setting of post-cesarean pregnancy. The results hold good both for normal (grades 1 and 2) and abnormal (grades 3) scars. MRI, however, does not offer any added advantage over sonographic scar thickness measurement for the differentiation of a normal (grades 1 and 2) from an abnormal (grade 3) scar.
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Affiliation(s)
- Gayatri Satpathy
- Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ishan Kumar
- Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Manjari Matah
- Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Verma
- Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Archivée: N° 155-Directive clinique sur l'accouchement vaginal chez les patientes ayant déjà subi une césarienne. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018. [DOI: 10.1016/j.jogc.2018.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gonsalves H, Al-Riyami N, Al-Dughaishi T, Gowri V, Al-Azri M, Salahuddin A. Use of Intracervical Foley Catheter for Induction of Labour in Cases of Previous Caesarean Section: Experience of a single tertiary centre in Oman. Sultan Qaboos Univ Med J 2016; 16:e445-e450. [PMID: 28003890 DOI: 10.18295/squmj.2016.16.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/19/2016] [Accepted: 08/02/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate rates of success and perinatal complications of labour induction using an intracervical Foley catheter among women with a previous Caesarean delivery at a tertiary centre in Oman. METHODS This retrospective cohort study included 68 pregnant women with a history of a previous Caesarean section who were admitted for induction via Foley catheter between January 2011 and December 2013 to the Sultan Qaboos University Hospital, Muscat, Oman. Patient data were collected from electronic and delivery ward records. RESULTS Most women were 25-35 years old (76.5%) and 20 women had had one previous vaginal delivery (29.4%). The most common indication for induction of labour was intrauterine growth restriction with oligohydramnios (27.9%). Most women delivered after 40 gestational weeks (48.5%) and there were no neonatal admissions or complications. The majority experienced no complications during the induction period (85.3%), although a few had vaginal bleeding (5.9%), intrapartum fever (4.4%), rupture of the membranes (2.9%) and cord prolapse shortly after insertion of the Foley catheter (1.5%). However, no cases of uterine rupture or scar dehiscence were noted. Overall, the success rate of vaginal birth after a previous Caesarean delivery was 69.1%, with the remaining patients undergoing an emergency Caesarean section (30.9%). CONCLUSION The use of a Foley catheter in the induction of labour in women with a previous Caesarean delivery appears a safe option with a good success rate and few maternal and fetal complications.
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Affiliation(s)
- Hazel Gonsalves
- Department of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Nihal Al-Riyami
- Department of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Tamima Al-Dughaishi
- Department of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Vaidayanathan Gowri
- Department of Obstetrics & Gynaecology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Mohammed Al-Azri
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ayesha Salahuddin
- Department of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Kwee A, Smink M, Van Der Laar R, Bruinse HW. Outcome of subsequent delivery after a previous early preterm cesarean section. J Matern Fetal Neonatal Med 2009; 20:33-7. [PMID: 17437197 DOI: 10.1080/14767050601036527] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the vaginal birth after cesarean section (VBAC) rate and risk of uterine rupture in women with a previous early preterm cesarean section. METHODS Women who delivered their first child by cesarean section between 26 and 34 weeks of gestation were included in a retrospective cohort study. Medical charts were reviewed for characteristics of the index pregnancy and delivery. Information of the subsequent delivery was obtained from the medical charts or from information of the attending gynecologist if the delivery was elsewhere. RESULTS Two hundred and forty-six women were included: 131 (53.3%) women had a subsequent pregnancy, 64 (26.0%) had no subsequent pregnancy, and from 51 (20.7%) women no information could be obtained. Of the 131 women with a subsequent pregnancy, 93 (71.0%) underwent a trial of labor (TOL) and 80 (86.0%) achieved a vaginal delivery, resulting in a VBAC rate of 61.1%. One uterine rupture occurred with favorable neonatal outcome. The uterine rupture rate for the whole cohort was 0.8% (95% CI 0.02-4.0) and for the group of women undergoing a TOL 1.1% (95% CI 0.03-5.8). CONCLUSION In this small series of women with a previous early preterm cesarean section the VBAC rate was high (61.1%) and the uterine rupture rate was 1.1%.
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Affiliation(s)
- Anneke Kwee
- Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, The Netherlands.
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Ekanem AD, Udoma EJ, Etuk SJ, Eshiet AI. Outcome of emergency caesarean sections in Calabar, Nigeria: Impact of the seniority of the medical team. J OBSTET GYNAECOL 2008; 28:198-201. [PMID: 18393019 DOI: 10.1080/01443610801912329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We set out to assess the maternal outcome of emergency caesarean sections in University of Calabar Teaching Hospital (UCTH) in relationship to the seniority and experience of medical personnel involved in the operation. This was a review of 349 cases of emergency caesarean sections in UCTH over a 2-year period (January 2000-December 2001). The sociodemographic data, antenatal booking status and clinical condition of the patients as well as the seniority of the medical staff who participated in the operations were extracted from the case notes of the patients. A total of 280 (80.0%) booked patients and 69 (20.0%) unbooked mothers were delivered by emergency caesarean sections. The consultants performed only 16.4% of the emergency caesarean sections, while the residents performed 83.6%. Similarly consultant anaesthetists administered anaesthesia in 12.9% of the cases. A total of 12 maternal deaths occurred from emergency caesarean sections in which six (1.7%) were due to sepsis, three (0.8%) due to severe haemorrhage and three (0.8%) due to anaesthetic complications. None of the deaths occurred in operations in which consultant obstetricians and anaesthetists were involved. The intraoperative blood loss was more in operations performed by the residents than in those performed by the consultants. Similarly, morbidity was higher in patients operated upon by residents. The maternal morbidity and mortality associated with emergency caesarean sections in UCTH would be reduced significantly if consultant obstetricians and anaesthetists were more involved in these operative procedures.
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Affiliation(s)
- A D Ekanem
- Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
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Russillo B, Sewitch MJ, Cardinal L, Brassard N. Comparing Rates of Trial of Labour Attempts, VBAC Success, and Fetal and Maternal Complications Among Family Physicians and Obstetricians. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008; 30:123-128. [DOI: 10.1016/s1701-2163(16)32735-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kwee A, Bots ML, Visser GHA, Bruinse HW. Obstetric management and outcome of pregnancy in women with a history of caesarean section in the Netherlands. Eur J Obstet Gynecol Reprod Biol 2007; 132:171-6. [PMID: 16904813 DOI: 10.1016/j.ejogrb.2006.07.017] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Revised: 05/26/2006] [Accepted: 07/03/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine mode of delivery and occurrence of uterine rupture in women with a previous caesarean section (CS) in the Netherlands. MATERIALS AND METHODS During a 1-year period 38 hospitals in the Netherlands registered prospectively mode of delivery, use of prostaglandins or oxytocin and occurrence of uterine rupture in all women with a previous CS. RESULTS There were 4569 women with a previous CS. Trial of labour (TOL) was attempted in 71.7%, of whom 76.0% delivered vaginally. The vaginal birth after caesarean (VBAC)-rate was 54.4%. Forty-nine uterine ruptures occurred (1.1%), of which 48 occurred during a TOL (1.5%). There were four perinatal deaths (1.2/1000 TOL) and 3 hysterectomies (0.9/1000 TOL) related to the rupture. Use of prostaglandin E2 alone or combined with oxytocin was significantly associated with an increased risk of uterine rupture (OR 6.8, 95% CI 3.2-14.3, OR 4.8, 95% CI 1.6-14.6, respectively). The same held for augmentation with oxytocin (OR 2.2, 95% CI 1.04-5.0). CONCLUSION The success rate of TOL was 76%, resulting in a VBAC rate of 54%. Uterine rupture occurred in 1.5% during a TOL, with a risk of perinatal death of 1.2 per 1000. The risk of uterine rupture increased significantly when labour was induced with prostaglandins alone or combined with oxytocin or when labour was augmented with oxytocin.
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Affiliation(s)
- Anneke Kwee
- University Medical Center Utrecht, Department of Obstetrics and Gynecology, Room Number KE 04.123.1, Lundlaan 6, 3584 EA Utrecht, The Netherlands.
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Aisien AO, Oronsaye AU. Vaginal birth after one previous caesarean section in a tertiary institution in Nigeria. J OBSTET GYNAECOL 2005; 24:886-90. [PMID: 16147643 DOI: 10.1080/01443610400018742] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Vaginal birth after one previous lower segment caesarean section represents one of the most significant and challenging issues in obstetric practice. A 5-year retrospective study was carried out at the University of Benin Teaching Hospital between January 1999 and December 2003, to determine the incidence, the maternal and fetal outcome following vaginal delivery after one previous caesarean section with a view to evaluating its safety and efficacy. There were 5234 deliveries, with 395 cases of one previous caesarean section, giving an incidence of 7.5%. The incidences of emergency caesarean section, elective caesarean section and spontaneous vaginal delivery following trial of vaginal delivery were 34.7%, 9.4% and 48.1%, respectively. During the study period there were 1317 cases of caesarean section, giving an incidence of 25.2% caesarean section rate. The incidence of one previous section among all caesarean section births was 30%. The major morbidity following vaginal delivery was uterine rupture with an incidence of 1.5% and hysterectomy of 0.8%. Three of the uterine ruptures occurred before admission because the patients laboured at home. One maternal death occurred as a result of uterine rupture and postpartum haemorrhage, giving a maternal mortality ratio of 19/100,000 and a case fatality rate of 0.3%. The corrected perinatal mortality rate was 15.2/1000, mainly from obstructed labour, abruptio placenta and fetal distress. Both maternal and fetal mortalities from vaginal birth after one previous section were significantly less than the respective overall maternal and fetal mortality from the institution. The 1-minute apgar score of babies delivered by elective section was significantly (P < 0.001) higher than the apgar score of babies delivered by emergency section and vaginally. There was only one patient with wound dehiscence at elective section without associated perinatal death. Vaginal delivery following caesarean section is relatively safe. However, women in developing countries will continue to require counselling to counter the myths of aversion to operative delivery even at the expense of losing their lives. Our hospitals should have adequate monitoring equipment for high-risk pregnancies so that patients and their babies can be assured of survival.
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Affiliation(s)
- A O Aisien
- Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin-City, Edo State, Nigeria.
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Uygur D, Tapisiz OL, Mungan T. Multiple repeat cesarean sections: Maternal and neonatal outcomes. Int J Gynaecol Obstet 2005; 89:284-5. [PMID: 15919400 DOI: 10.1016/j.ijgo.2005.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Revised: 02/25/2005] [Accepted: 03/02/2005] [Indexed: 11/15/2022]
Affiliation(s)
- D Uygur
- Zekai Tahir Burak Women Health Care, Research and Education Hospital, Ankara, Turkey.
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Uygur D, Gun O, Kelekci S, Ozturk A, Ugur M, Mungan T. Multiple repeat caesarean section: is it safe? Eur J Obstet Gynecol Reprod Biol 2005; 119:171-5. [PMID: 15808374 DOI: 10.1016/j.ejogrb.2004.07.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Revised: 06/15/2004] [Accepted: 07/23/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We aimed to evaluate the obstetric outcome of patients without obstetric risks, who had two or more previous caesarean sections (C/S) prior to the current pregnancy, which was managed by caesarean section in our obstetric department. METHODS We studied the case notes of 602 women who had a repeat caesarean section in our unit between May 2002-June 2003. We then compared the two groups: (1) those who had two or more previous caesarean sections and (2) those who had only one previous caesarean section. RESULTS In the study group, while dense intraperitoneal adhesions were present in 3.6% of the patients, they were not found in control group. This difference was statistically significant (P < 0.05). Uterine wound separation rate was 1.9% in the study group and none of the patients in control group had uterine wound separation, which was statistically significant also (P < 0.05). There was no statistically significant association between Apgar scores and number of previous caesarean sections. Postoperative complication rates did not differ between the two groups (P > 0.05). CONCLUSION Patients without any obstetric risks, with two or more previous caesarean sections had significantly more dense adhesions and uterine wound separations in the current caesarean section compared to patients with one previous caesarean section. But, maternal and fetal mortality and morbidity in women who have two or more previous caesarean sections did not differ from the patients with one previous caesarean section.
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Affiliation(s)
- Dilek Uygur
- Zekai Tahir Burak Women's Hospital, Gynecology and Obstetrics, 33 Cadde, 16/27 Fatih Sultan Me., Karakusunlar, Cankaya, 06520 Ankara, Turkey.
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Directive clinique sur l’accouchement vaginal chez les patientes ayant déjà subi une césarienne. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005. [DOI: 10.1016/s1701-2163(16)30189-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Martel MJ, MacKinnon CJ. Guidelines for Vaginal Birth After Previous Caesarean Birth. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005; 27:164-88. [PMID: 15943001 DOI: 10.1016/s1701-2163(16)30188-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To provide evidence-based guidelines for the provision of a trial of labour (TOL) after Caesarean section. OUTCOME Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean (VBAC) and repeat Caesarean section. EVIDENCE MEDLINE database was searched for articles published from January 1, 1995, to February 28, 2004, using the key words "vaginal birth after Caesarean (Cesarean) section". The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam. RECOMMENDATIONS 1. Provided there are no contraindications, a woman with 1 previous transverse low-segment Caesarean section should be offered a trial of labour (TOL) with appropriate discussion of perinatal risks and benefits. The process of informed consent with appropriate documentation should be an important part of the birth plan in a woman with a previous Caesarean section (II-2B). 2. The intention of a woman undergoing a TOL after Caesarean section should be clearly stated, and documentation of the previous uterine scar should be clearly marked on the prenatal record (II-2B). 3. For a safe labour after Caesarean section, a woman should deliver in a hospital where a timely Caesarean section is possible. The woman and her health care provider must be aware of the hospital resources and the availability of obstetric, anesthetic, pediatric, and operating-room staff (II-2A). 4. Each hospital should have a written policy in place regarding the notification and (or) consultation for the physicians responsible for a possible timely Caesarean section (III-B). 5. In the case of a TOL after Caesarean, an approximate time frame of 30 minutes should be considered adequate in the set-up of an urgent laparotomy (III-C). 6. Continuous electronic monitoring of women attempting a TOL after Caesarean section is recommended (II-2A). 7. Suspected uterine rupture requires urgent attention and expedited laparotomy to attempt to decrease maternal and perinatal morbidity and mortality (II-2A). 8. Oxytocin augmentation is not contraindicated in women undergoing a TOL after Caesarean section (11-2A). 9. Medical induction of labour with oxytocin may be associated with an increased risk of uterine rupture and should be used carefully after appropriate counselling (II-2B). 10. Medical induction of labour with prostaglandin E2 (dinoprostone) is associated with an increased risk of uterine rupture and should not be used except in rare circumstances and after appropriate counselling (II-2B). 11. Prostaglandin E1 (misoprostol) is associated with a high risk of uterine rupture and should not be used as part of a TOL after Caesarean section (II-2A). 12. A foley catheter may be safely used to ripen the cervix in a woman planning a TOL after Caesarean section (II-2A). 13. The available data suggest that a trial of labour in women with more than 1 previous Caesarean section is likely to be successful but is associated with a higher risk of uterine rupture (II-2B). 14. Multiple gestation is not a contraindication to TOL after Caesarean section (II-2B). 15. Diabetes mellitus is not a contraindication to TOL after Caesarean section (II-2B). 16. Suspected fetal macrosomia is not a contraindication to TOL after Caesarean section (II-2B). 17. Women delivering within 18 to 24 months of a Caesarean section should be counselled about an increased risk of uterine rupture in labour (II-2B). 18. Postdatism is not a contraindication to TOL after Caesarean section (II-2B). 19. Every effort should be made to obtain the previous Caesarean section operative report to determine the type of uterine incision used. In situations where the scar is unknown, information concerning the circumstances of the delivery is helpful in determining the likelihood of a low transverse incision. If the likelihood of a low transverse incision is high, a TOL after Caesarean section can be offered (II-2B). VALIDATION These guidelines were approved by the Clinical Practice Obstetrics and Executive Committees of the Society of Obstetricians and Gynaecologists of Canada.
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van Bogaert LJ. Mode of delivery after one cesarean section. Int J Gynaecol Obstet 2004; 87:9-13. [PMID: 15464769 DOI: 10.1016/j.ijgo.2004.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2004] [Revised: 05/19/2004] [Accepted: 05/19/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To investigate labor patterns and mode of delivery of aginal births after cesarean (VBAC) versus unsuccessful trial of labor after cesarean (TOLAC) in a South African district hospital, and the influence of the indication for the primary cesarean section (C-section) on the subsequent mode of delivery. METHODS Retrospective audit of the partogram of 202 VBAC and 382 repeat C-section. There were 108 elective repeat cesarean deliveries (ERCD) and 274 emergency repeat C-sections after unsuccessful TOLAC. The indication of the primary C-section was known in 127: 43 (33.9%) VBAC and 84 (66.1%) repeat C-sections. RESULTS The indication for the primary C-section in terms of recurrent/non-recurrent did not affect the subsequent mode of delivery (chi(2)=3.5; P=0.06; OR 0.49, 95% CI 0.23-1.04). The indication of the primary C-section in terms of dysfunctional/non-dysfunctional labor did not reoccur in the same parturients (chi(2)=0.01; P=0.91; OR 0.94, 95% CI 0.35-2.55). CONCLUSION Dysfunctional labor accounted for most primary and repeat emergency C-sections, but not as a recurrent condition in the same parturients.
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Affiliation(s)
- L-J van Bogaert
- Department of Obstetrics and Gynecology, MEDUNSA Satellite Campus, Philadelphia Hospital, Dennilton, South Africa.
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Grisaru S, Samueloff A. Primary nonmedically indicated cesarean section ("section on request"): evidence based or modern vogue? Clin Perinatol 2004; 31:409-30, vii. [PMID: 15325529 DOI: 10.1016/j.clp.2004.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cesarean section, initially described as an emergency operative procedure for delivering moribund parturients, is now advocated by many as a routine technique with major advantages over vagi-nal delivery. In fact, it has been suggested that labor and vaginal delivery are no longer the desired consequence of pregnancy, a conclusion that reflects perceived medical advantages and patient and physician convenience. This article systematically reviews the various medical implications to the mother and infant of this procedure in the hope of facilitating a more rational approach to this spreading and controversial phenomenon.
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Affiliation(s)
- Sorina Grisaru
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, PO Box 76100, Jerusalem 91031, Israel.
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Archivée: Directive Clinique Sur L’accouchement Vaginal Chez Les Patientes Ayant Déjà Subi Une Césarienne. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2004. [DOI: 10.1016/s1701-2163(16)30615-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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