Obstetrics & Gynecology Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2001;98:652-655
© 2001 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bujold, E.
Right arrow Articles by Gauthier, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bujold, E.
Right arrow Articles by Gauthier, R. J.

ORIGINAL RESEARCH

Should We Allow a Trial of Labor After a Previous Cesarean for Dystocia in the Second Stage of Labor?

Emmanuel Bujold, MD and Robert J. Gauthier, MD

From the Department of Obstetrics and Gynecology, Hôpital Ste-Justine and Université de Montréal, Montreal, Quebec, Canada

Address reprint requests to: Robert J. Gauthier, MD, Department of Obstetrics and Gynecology, Hôpital Ste-Justine and Université de Montréal, 3175 Côte Ste-Catherine, Montreal, Quebec, Canada H3T 1C5; E-mail: robert_gauthier{at}ssss.gouv.qc.ca.

OBJECTIVE: To estimate the rate of successful vaginal birth including operative vaginal delivery in patients with a previous cesarean for cephalopelvic disproportion in the second stage of labor.

METHODS: Data from all patients who underwent trial of labor after a previous cesarean between 1990 and 2000 at our tertiary care institution were analyzed. Medical records were reviewed and data collected for the following variables: indication for the previous cesarean, birth weight and cervical dilatation at previous cesarean delivery, as well as the mode of delivery (spontaneous, vacuum, forceps, cesarean) and the birth weight for the subsequent pregnancy. Pearson’s {chi}2 test and one-way analysis of variance were used for statistical analyses.

RESULTS: There were 2002 patients included in the study. Two hundred fourteen (11%) had their previous cesarean for dystocia in the second stage of labor, 654 (33%) for dystocia in the first stage of labor, and 1134 (57%) for other indications. The vaginal birth after cesarean success rate was 75.2% (P = .015 vs other indications), 65.6% (P < .001 vs other indications), and 82.5%, respectively. The rate of operative vaginal delivery was 15%, 12%, and 10% (P = .109).

CONCLUSION: A trial of labor is reasonable in women whose previous cesarean was for dystocia in the second stage of labor. In this series, patients who underwent a trial of labor after a previous cesarean for dystocia in the second stage had 75.2% (95% confidence interval 69.5, 81.0) chance of achieving vaginal delivery.




This article has been cited by other articles:


Home page
 Obstet GynecolHome page
L. Carbillon, M. Uzan, A. Batallan, E. Bujold, S. H. Mehta, and R. J. Gauthier
Should We Allow a Trial of Labor After a Previous Cesarean for Dystocia in the Second Stage of Labor?
Obstet. Gynecol., March 1, 2002; 99(3): 520 - 521.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Obstetricians and Gynecologists.