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Updated: May 15, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Second stage disorders in patients following a previous cesarean section: vacuum versus repeated cesarean section
Roy Kessous1, Dan Tirosh, Adi Y Weintraub
1Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer-Sheva 84101, Israel. kessousr@bgu.ac.il
Objective:
To investigate whether vacuum extraction due to failure of labor to progress (dystocia) during the second stage in a delivery following a previous cesarean section (CS) is related to increased adverse maternal and perinatal outcomes as compared with repeated CS.
Study Design:
A retrospective cohort study of pregnancy and delivery outcomes of patients in their second deliveries attempting a vaginal birth after cesarean (VBAC) following one CS was conducted. Patients who delivered by vacuum extraction were compared with patients who underwent a repeated CS for failure of labor to progress during the second stage.
Results:
During the study period, 319 patients with a previous CS suffered from a prolonged second stage of labor in their second delivery. Of these, 184 underwent vacuum extraction and 135 patients underwent a repeated CS. No significant differences in relevant pregnancy complications such as perineal lacerations, uterine rupture, and post-partum hemorrhage and perinatal outcomes were noted between the groups. There were no cases of perinatal mortality in our study.
Conclusion:
When managing second stage labor disorders, vacuum extraction does not seem to be an unsafe procedure in patients with a previous CS.
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