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Archives of Gynecology and Obstetrics

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22.01.2018 | Maternal-Fetal Medicine

Trial of labor following one previous cesarean delivery: the effect of gestational age

verfasst von: Maya Ram, Liran Hiersch, Eran Ashwal, Daniel Nassie, Anat Lavie, Yariv Yogev, Amir Aviram

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2018

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Abstract

Purpose

To stratify maternal and neonatal outcomes of trials of labor after previous cesarean delivery (TOLAC) by gestational age.

Methods

Retrospective cohort study of all singleton pregnancies with one previous cesarean delivery in TOLAC at term between 2007 and 2014. We compared outcomes of delivery at an index gestational week, with outcomes of women who remained undelivered at this index gestational week (ongoing pregnancy). Odds ratios and 95% confidence intervals were adjusted for maternal age, previous vaginal delivery, induction of labor, epidural use, presence of meconium, and birth weight > 4000 g.

Results

Overall, 2849 women were eligible for analysis. Of those, 2584 (90.7%) had a successful TOLAC and 16 women (0.56%) had uterine rupture. Those rates did not differ significantly for any gestational age (GA) group. Following adjustment for possible confounders, GA was not found to be independently associated with adverse maternal or neonatal outcomes.

Conclusion

Among women at term with a single previous cesarean delivery, GA at delivery was not found to be an independent risk factor for TOLAC success or uterine rupture. We suggest that GA by itself will not serve as an argument for or against TOLAC.

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Titel: Trial of labor following one previous cesarean delivery: the effect of gestational age
verfasst von: Maya Ram
Liran Hiersch
Eran Ashwal
Daniel Nassie
Anat Lavie
Yariv Yogev
Amir Aviram
Publikationsdatum: 22.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4677-9

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Trial of labor following one previous cesarean delivery: the effect of gestational age

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Purpose

Methods

Results

Conclusion

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