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Trial of labor after cesarean: Maternal and neonatal outcomes from the Consortium on Safe Labor
J M Phillips1, D Polyakov1, R L Amdur2
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Background:
The aim of our study is to describe maternal and neonatal morbidity and mortality in patients undergoing trial of labor after cesarean from the Consortium on Safe Labor.
Methods:
This was a secondary analysis of the Consortium on Safe Labor database, a retrospective cohort study over a 7 year study period. Maternal and neonatal outcomes were evaluated based on desired delivery mode: planned elective repeat cesarean delivery or trial of labor after cesarean.
Results:
Of 9858 patients in our analysis, our study population had 4400 patients (45%) who desired trial of labor after cesarean and 5458 patients (55%) who desired elective repeat cesarean delivery. Women who attempted trial of labor after cesarean compared to those who had an elective repeat cesarean delivery were more likely to have an obstetric hemorrhage (adjusted odds ratio 1.6; 95% CI 1.3 -2.0) and blood transfusion (adjusted odds ratio 2.3; 95% CI 1.6 -3.2).
Conclusion:
Maternal morbidity in women undergoing trial of labor after cesarean was predominantly hemorrhage-related.
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