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Vaginal birth after two or more cesarean sections: a five-year experience
Birth (Berkeley, Calif.)
|September 1, 1990
Summary
Trial of labor after two or more cesarean births is safe and successful. Women undergoing trial of labor experienced fewer complications and shorter hospital stays compared to elective repeat cesarean sections.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Vaginal birth after cesarean (VBAC) is increasingly accepted for women with one prior cesarean.
- Limited evidence exists on the safety of VBAC for women with two or more prior cesarean births.
Purpose of the Study:
- To evaluate the safety and success of a trial of labor in patients with two or more low transverse cesarean deliveries.
Main Methods:
- Retrospective chart review of 170 patients with at least two prior low transverse cesarean deliveries.
- Analysis of outcomes for 35 patients who underwent a trial of labor.
Main Results:
- A successful vaginal delivery occurred in 77% (27 out of 35) of women attempting trial of labor.
- No increased maternal or fetal morbidity or mortality was observed.
- Women in the trial of labor group had fewer postpartum complications and shorter hospital stays.
Conclusions:
- Trial of labor appears to be a safe and successful alternative to elective repeat cesarean section for carefully selected patients with two or more prior cesarean births.
- Further research with larger patient cohorts is warranted to confirm these findings.