31: Trial of labor after previous cesarean section versus repeat cesarean section: are patients making an informed decision?

2012 ◽  
Vol 206 (1) ◽  
pp. S21
Author(s):  
Sarah Bernstein ◽  
Shira Matalon-Grazi ◽  
Barak Rosenn
Keyword(s):  
Cesarean Section ◽  
Informed Decision ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Section Versus ◽  
Repeat Cesarean Section ◽  
Previous Cesarean

scholarly journals Trail of labor versus elective repeat cesarean section: a comparison of morbidity and mortality at tertiary care teaching hospitals in India

2018 ◽  
Vol 7 (11) ◽  
pp. 4476
Author(s):  
Balwan Singh Dhillon ◽  
Nomita Chandhiok ◽  
M. Vishnu Vardhana Rao
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Management Practices ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Repeat Cesarean Section ◽  
Elective Repeat Cesarean ◽  
Previous Cesarean

Background: As cesarean birth rates continue to rise, more women are faced with the choice of planning a vaginal delivery or a repeat cesarean section after a previous cesarean section. The objective of this prospective study was to study the morbidities and mortality of women attempting a trial of labor after cesarean (TOLAC) versus elective repeat cesarean section (El-RCS).Methods: Prospective data was recorded on management practices, associated complications and morbidity & mortality for a period of 8 months on 15664 consecutive cases of previous cesarean section reporting at 30 medical colleges/ teaching hospitals for delivery.Results: A trial of labor was planned in 25.8% (4035) women and 34.5% (5399) women underwent elective repeat cesarean section and rest had emergency repeat cesarean section. Overall maternal morbidity due to any cause was 20.7% among El-RCS as compared to 14.2% in TOLAC which was statistically significant (OR: 1.57, CI: 1.41-1.76, P=0.00). Blood loss of more than 1000ml was around 8.0% among TOLAC where as in El-RCS it was 8.8% (OR: 0.89, CI: 0.77-1.94, p=0.14 not statistically significant). Blood transfusion was given in 3.7% in TOLAC where as in El-RCS it was given in 6.5% (OR: 0.56, CI: 0.45-0.68, p=0.00 highly significant).  Complication like dehiscence of scar was similar in both groups. Post-operative complication were seen in 2.8% cases in TOLAC where as in El-RCS it was 5.8% (OR: 0.47, CI: 0.38-0.59, p=0.00 highly significant). Uterine rupture was 0.3% in TOLAC where as in El-RCS it was 0.7% (OR: 0.43, CI: 0.21-0.87, p=0.009 statistically significant). Maternal mortality was reported in 0.2% cases of TOLAC as compared to 0.1% cases in El-RCS (p=0.17) which was not statistically significant.Conclusions: Maternal morbidity was found to be more in elective repeat cesarean section than trial of labor after cesarean section.

“THE WAR WHEN YOU ALREADY HAVE A SCAR” -STUDY OF DIFFICULTIES IN EXTRACTION OF BABY IN PREVIOUS CESAREAN SECTION

2021 ◽  
pp. 68-70
Author(s):  
Ashwini N Hotkar ◽  
Prashanth Bhingare ◽  
Srinivas Gadappa ◽  
Sasireka Kuppuswami ◽  
Priyanka Kesharwani
Keyword(s):  
Cesarean Section ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Tertiary Centre ◽  
Risk Pregnancy ◽  
Pregnancy Status ◽  
Repeat Cesarean Section ◽  
Time Of Operation ◽  
Previous Cesarean

Background:The study of intraoperative difculties in extraction of baby in previous cesarean section Method:This is a tertiary centre based prospective observational study conducted in the department of Obstetrics and Gynaecology, at our tertiary health Care hospital between the study period October 2018-september 2020.A total 1200 cases of patients with previous cesarean section were studied . They are divided into number of previous scar and the intraoperative surgical difculty encountered by the surgeon in delivering the baby based on the consequences of scar from previous cesarean section. Results: The incidence of repeat cesarean section being 9.4%, among which only of 38% cases were encountered with difculties in cesarean section by the surgeons in the institute. Among which 26.3% cases were encountered with Adhesions,4.2% with difculty in delivery of baby, 1.5% cases needed assistance by senior surgeon in delivering baby and 6% among that had poor perinatal outcome. Conclusions: The common clinical entity of “previous cesarean section” in subsequent pregnancies, giving a high risk pregnancy status to the reference pregnancy. The risks associated with repeat cesarean section can be reduced by many measures including-vigorous ANC surveillance to reduce the risk of primary CS, intervention by operative vaginal delivery whenever needed, giving trial of labor in cesarean section(TOLAC) with skilled monitoring, counselling of patients regarding perineal exercises in pregnancy. Most complications will be recognized at the time of operation and easily corrected either by the operating surgeon or by seeking assistance from other specialties

scholarly journals Outcomes of induction in trial of labor after cesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 1076
Author(s):  
Anubha Varshney ◽  
Zehra Mohsin
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
Control Group ◽  
Study Group ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Previous Cesarean

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.

Trial of labor in patients with a previous cesarean section: does maternal age influence the outcome?

2004 ◽  
Vol 190 (4) ◽  
pp. 1113-1118 ◽  
Author(s):  
Emmanuel Bujold ◽  
Ahmad O Hammoud ◽  
Israel Hendler ◽  
Susan Berman ◽  
Sean C Blackwell ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Maternal Age ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Previous Cesarean
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