Trial of Labor and Vaginal Birth after Three Previous Cesarean Sections: Report of Two Special Cases

2022 ◽  
Author(s):  
Arrigo Fruscalzo ◽  
Marwa Elgendi ◽  
Marcus Gantert
Keyword(s):  
Vaginal Birth ◽  
Cesarean Sections ◽  
Natural Childbirth ◽  
Case Presentation ◽  
Trial Of Labor ◽  
Detailed Explanation ◽  
Special Cases ◽  
Potential Risks ◽  
First Time ◽  
Previous Cesarean

Abstract Background Natural childbirth could represent a deeply rooted need for many women, even in exceptional situations such as after 3 previous caesarean sections. Case presentation The first patient, a 28-year-old 6th gravida and 3rd para, first presented in the 40+3 week of pregnancy desiring a vaginal birth, after all the other hospitals in the area had refused her request. A detailed explanation of potential risks was given and, when 2 days later contractions started, she gave birth to a newborn of 4450 g spontaneously, without complications. A month later, a second woman, 42 years old, 5th gravida, 3rd para, read about the above-mentioned case on social media and decided to attempt a natural delivery after 3 caesarean sections at our hospital as well. She presented herself for the first time in the 41+1 week of pregnancy in our delivery room with an onset of labor after rupture of the membranes and gave birth on the same day, spontaneously without complications, to a 4150 g heavy healthy newborn. Conclusions The wish to attempt a spontaneous birth after 3 previous caesarean sections can be deeply anchored and should be professionally approached by obstetricians, even if counseling and management can be challenging.

Vaginal Birth after Two Previous Cesarean Sections versus Elective Repeated Cesarean: A Retrospective Study

2020 ◽  
Vol 37 (S 02) ◽  
pp. S84-S88
Author(s):  
Rossella De Leo ◽  
Domenico Antonio La Gamba ◽  
Paolo Manzoni ◽  
Raffaella De Lorenzi ◽  
Sonia Torresan ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Final Analysis ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Trial Of Labor ◽  
Primary Care Hospital ◽  
Pros And Cons ◽  
Gestational Age At Birth ◽  
Previous Cesarean

Objective Trial of labor after cesarean delivery (TOLAC) is a common practice worldwide but the evidence is still scant regarding this practice in women who underwent 2 previous cesareans. The purpose of this study is to retrospectively review our experience with vaginal birth after two previous cesarean sections (VBA2C), with specific attention to the indications for previous cesarean and to the women's motivation for attempting trial of labor. Study Design This was a retrospective cohort study conducted in a primary care hospital between January 2011 and December 2019. Inclusion criteria were: singleton pregnancies, absence of morphological abnormalities at ultrasonographic screening of the second trimester (or at any other stage of pregnancy), and two previous cesarean sections. Results The final analysis included 114 cases for maternal and neonatal outcomes. In total, 40.4% of women chose trial of labor after two cesarean delivery (TOLA2C group). TOLA2C was associated with a success rate of 76.1%, a higher gestational age at birth, and a shorter hospital stay, compared with elective repeated cesarean delivery group. There were no significant differences in the rate of Apgar scores at 5 minutes <7 between both groups. The percentage of successful TOLA2C in women with prior vaginal delivery was 92.8%. Factors related to failed TOLA2C included failure to progress (3/11, 27.3%), nonreassuring fetal heart rate (3/11, 27.3%), and no onset of spontaneous labor after premature rupture of membranes (5/11, 45.4%). In the group of TOLA2C, more than 70% accepted to travel more than 45 minutes to reach our hospital, with the aim to attempt VBA2C. Conclusion TOLA2C is a possible option for both mothers and neonates in selected cases. Adequate counseling about pros and cons of TOLA2C is mandatory. The woman's motivation represents a key element to determine the success of VBA2C. Key Points

scholarly journals Conservative Treatment of Huge Retroperitoneal Hematoma Postpartum: Case Report

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Sedigheh Ghasemian Dizajmehr ◽  
Farzaneh Rashidi Fakari ◽  
Mohsen Ghasemian
Keyword(s):  
Caesarean Section ◽  
Conservative Treatment ◽  
Retroperitoneal Hematoma ◽  
Proper Treatment ◽  
Cesarean Sections ◽  
Term Pregnancy ◽  
Case Presentation ◽  
Successful Case ◽  
Fluid Leak ◽  
Previous Cesarean

Introduction: Retroperitoneal hematoma are an important factor for hospitalization in patients with trauma and proper treatment is still under discussion and Controversial. We describe a successful case of conservative treatment of huge hematoma after cesarean section. Case presentation: An Iranian 34-year-old multigravida(G4L3) woman with three previous cesarean sections from Urmia province presented to our hospital with amniotic fluid leak. She had full-term pregnancy. Caesarean section was done. One day after caesarean section, she became dyspnea and had chest pain in left side. Embolism is suspected and enoxaparin was administered. According, hemoglobin decreased (HB:6.2) after administered the second dose of enoxaparin and a clear dullness percussion led tosuspected to hemorrhage and retroperitoneal hematoma was discontinued enoxaparin. After the patient is stable, the patient was discharged and retroperitoneal hematoma was followed up by ultrasonography and conservative treatment. Conclusion: Conservative treatment of retroperitoneal hematoma postpartum with good clinical evolution, depends on status of the patient, cause of injury and its evolution.

scholarly journals Trial of labor after previous cesarean delivery (TOLAC) and association of BMI and previous vaginal delivery with frequency of VBAC

2016 ◽  
Vol 15 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Huma Tasleem ◽  
Haider Ghazanfar
Keyword(s):  
Cesarean Section ◽  
Success Rate ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Health Centre ◽  
Tertiary Care ◽  
Vaginal Birth ◽  
Trial Of Labor ◽  
Emergency Cesarean ◽  
Previous Cesarean

Objectives: To determine the frequency of successful Vaginal Birth after One Cesarean Section in our tertiary care institution and to determine the causes of its failure.Material and Methods: This study was conducted in department of Obstetrics and Gynecology of Shifa International Hospital and Shifa Foundation Community Health Centre Islamabad Pakistan from Feb 2011 to Dec 2014. This study included 592 patients who presented in labor room emergency reception of Obs/Gynae department at term with previous one scar having fulfilled the laid down inclusion criteria for VBAC during ante-natal care. The patients were admitted in hospital and were allowed to proceed for spontaneous labor under vigilant monitoring on complications of trial of scar. Immediate emergency cesarean sections were performed, where indicated.Results: Out of 592 patients 70.7% were delivered vaginally after previous one cesarean section and 29.3% had emergency cesarean section. Leading indications for repeat cesarean section was fetal distress, failure to progress and scar tenderness. No maternal and fetal complication occurred in our study. The success rate of Trial of labor after one previous cesarean delivery was lower in obese (64.38%) as compared to non-obese women (82.06%) (p<0.001). Women with previous successful vaginal delivery had a success rate of 88.2% compared with 62.25% in women without such a history (OR 4.4; 95% CI 2.7-7.2 p <0.001).Conclusion: Vaginal birth after one lower segment cesarean section should be encouraged with vigilant monitoring provided no obstetric contra-indication to vaginal birth exists.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.546-550

Vaginal birth after two or more previous cesarean sections

1987 ◽  
Vol 156 (3) ◽  
pp. 565-566 ◽  
Author(s):  
George Farmakides ◽  
Roger Duvivier ◽  
Harold Schulman ◽  
Elizabeth Schneider ◽  
John Biordi
Keyword(s):  
Vaginal Birth ◽  
Cesarean Sections ◽  
Previous Cesarean

scholarly journals 630: Factors influencing a successful trial of labor following two previous cesarean sections

2017 ◽  
Vol 216 (1) ◽  
pp. S368-S369
Author(s):  
James Sargent ◽  
Leah M. Savitsky ◽  
Yvonne W. Cheng ◽  
Aaron B. Caughey
Keyword(s):  
Cesarean Sections ◽  
Trial Of Labor ◽  
Successful Trial ◽  
Factors Influencing ◽  
Previous Cesarean

scholarly journals Trial of Vaginal Birth After Caesarean (VBAC): Sharing Experience From a Tertiary Care Center of Eastern Nepal

2018 ◽  
Vol 7 (1) ◽  
pp. 18-25
Author(s):  
Sita Pokhrel Ghimire ◽  
Ashima Ghimire ◽  
Aruna Pokharel ◽  
Sabina Lamichhane ◽  
Mahanand Kumar
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care ◽  
College Teaching ◽  
Vaginal Birth ◽  
Attractive Alternative ◽  
Medical College ◽  
Trial Of Labor ◽  
Previous Cesarean ◽  
Vaginal Birth After Caesarean

Background: Rising rates of cesarean section is a matter of great concern and trial of labor in previous cesarean section women is an attractive alternative. Vaginal Birth After Caesarean (VBAC) may be one of the strategy developed to control the rising rate of cesarean deliveries in our country. Analyzing outcome of previous caesarean pregnancies will provide an insight for reducing the caesarean rates and formulating protocols and policies for trial of labor. The purpose of this study is to evaluate the pregnancy outcome in previous caesarean section women with VBAC trial with the hope of avoiding unnecessary repeat caesarean section rates. Methodology: It is a cross-sectional observational institute based study carried out in Nobel Medical College Teaching Hospital from 15th March 2017 to 14th March 2018 after the approval from Institutional Review Committee (IRC). This consists of patient with past history of cesarean section, who delivered in NMCTH during the study period and meeting the Royal College of Obstetrics and Gynecology (RCOG) inclusion criteria for VBAC. Feto-maternal outcomes were analysed. Results: There were 1225 previous cesarean cases, among them, we did VBAC trial in 135(11%) patients, 99 (73.33%) had successful vaginal delivery whereas 36(26.66%) could not do the same after labor trial. Feto-maternal outcome was better in VBAC patients than cesarean group.No maternal and neonatal mortality occurred. Conclusion: In the country like ours where rate of caesarean section is increasing alarmingly we have to try VBAC in appropriate group of patients. National policy and guidelines are necessary after large multicenter prospective studies. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 18-25

scholarly journals Labor patterns in Chinese women in Fuzhou attempting vaginal birth after previous cesarean delivery: a retrospective cohort study

2019 ◽  
Vol 47 (12) ◽  
pp. 6091-6099
Author(s):  
Lianghui Zheng ◽  
Qinjian Zhang ◽  
Qiuping Liao ◽  
Rongxin Chen ◽  
Rongli Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chinese Women ◽  
Vaginal Birth ◽  
Previous Cesarean Section ◽  
Cervical Dilation ◽  
Trial Of Labor ◽  
Previous Cesarean

Objective To investigate the characteristics of labor in Chinese women who successfully have vaginal birth after cesarean section (VBAC). Methods A retrospective cohort study was conducted in a hospital with 1000 beds between January 1 2015 and December 31 2017. A total 657 parturients with VBAC were selected. Women were divided into two groups according to previous cesarean section with or without trial of labor. Labor curves were analyzed and interval-censored regression was used to estimate the duration of labor. Results The 95th percentile for the first stage of labor in VBAC was 13.03 hours, and labor accelerated after 4 cm of cervical dilation in both groups. The dilation rate in the trial of labor group was superior to that in the non-trial of labor group at 6–10 cm of dilation. After 6 cm, labor accelerated much faster in the trial of labor group than in the non-trial of labor group. Conclusions Management of labor in parturients with VBAC whose cervical dilation is >6 cm should be treated differently according to previous cesarean section with or without trial of labor. If there is trial of labor in a previous delivery, the duration of labor should be shortened.

Sign in / Sign up

Export Citation Format

Share Document