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repeated attempts of VBAC

Mark P Hehir, Adam Mackie, Michael S Robson
OBJECTIVE: To examine the outcomes of vaginal birth after cesarean (VBAC) in women, in spontaneous labor, delivering after 37 weeks' gestation at an institution where trial of labor after a previous cesarean delivery (TOLAC) is encouraged and management of labor is standardized. METHODS: This retrospective cohort study included 3071 women with one previous cesarean only and no vaginal delivery who underwent a trial of labor from 2001 to 2011. Women were managed using the standardized "active management of labor" intrapartum protocol...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Maralyn Foureur, Sabera Turkmani, Danielle C Clack, Deborah L Davis, Lyndall Mollart, Bernadette Leiser, Caroline S E Homer
PROBLEM: One of the greatest contributors to the overall caesarean section rate is elective repeat caesarean section. BACKGROUND: Decisions around mode of birth are often complex for women and influenced by the views of the doctors and midwives who care for and counsel women. Women may be more likely to choose a repeat elective caesarean section (CS) if their health care providers lack skills and confidence in supporting vaginal birth after caesarean section (VBAC)...
June 15, 2016: Women and Birth: Journal of the Australian College of Midwives
Valerie L Peddie, Natalie Whitelaw, Grant P Cumming, Siladitya Bhattacharya, Mairead Black
BACKGROUND: The United Kingdom (UK) caesarean section (CS) rate is largely determined by reluctance to augment trial of labour and vaginal birth. Choice between repeat CS and attempting vaginal birth after CS (VBAC) in the next pregnancy is challenging, with neither offering clear safety advantages. Women may access online information during the decision-making process. Such information is known to vary in its support for either mode of birth when assessed quantitatively. Therefore, we sought to explore qualitatively, the content and presentation of web-based health care information on birth after caesarean section (CS) in order to identify the dominant messages being conveyed...
2015: BMC Pregnancy and Childbirth
Stephen Robson, Beth Campbell, Gabrielle Pell, Anne Wilson, Kate Tyson, Caroline de Costa, Michael Permezel, Cindy Woods
BACKGROUND: The proportion of women who plan for a repeat elective caesarean section (CS) is one of the major determinants of the overall rate of CS, and programs aiming to reduce the rate of CS have not been greatly successful. To date, there appear to have been no large studies directly addressing paternal influences on decision-making regarding vaginal birth after caesarean (VBAC). This study aimed to compare the reactions of fathers and mothers to the prospect of VBAC. METHODS: Couples were recruited from three Australian hospitals and were eligible with a singleton pregnancy, a normal morphology ultrasound, and where there was no condition in the new pregnancy that would preclude a vaginal birth...
June 2015: Australian & New Zealand Journal of Obstetrics & Gynaecology
Daniele S Feldman, D Lisa Bollman, Moshe Fridman, Lisa M Korst, Samia El Haj Ibrahim, Arlene Fink, Kimberly D Gregory
OBJECTIVE: We sought to determine the impact of the laborist staffing model on cesarean rates and maternal morbidity in California community hospitals. STUDY DESIGN: This is a cross-sectional study comparing cesarean rates, vaginal birth after cesarean rates, composite maternal morbidity, and severe maternal morbidity for laboring women in California community hospitals with and without laborists. We conducted interviews with nurse managers to obtain data regarding hospital policies, practices, and the presence of laborists, and linked this information with patient-level hospital discharge data for all deliveries in 2012...
October 2015: American Journal of Obstetrics and Gynecology
Lauren F Damle, Kathy Wilson, Chun-Chih Huang, Helain J Landy, Veronica Gomez-Lobo
STUDY OBJECTIVE: To determine the rate of elective repeat cesarean delivery (CD), vaginal birth after cesarean (VBAC) attempt, and VBAC success in adolescent mothers presenting for delivery of a second child after a prior CD compared to their adult counterparts. DESIGN: Retrospective cohort study analyzing data from the Consortium on Safe Labor Database which includes data for 228,668 deliveries from 2002 to 2008. SETTING: 19 hospitals within 12 institutions in the United States...
August 2015: Journal of Pediatric and Adolescent Gynecology
Martyna Micek, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Maria Krowicka, Iwona Szymusik, Miroslaw Wielgos
OBJECTIVE: A retrospective analysis of the course of labour in patients after one caesarean section (CS) and of factors influencing successful attempt of vaginal birth after caesarean (VBAC). DESIGN: A group of 296 patients after one CS was divided into: group G1 (206 patients) - elective CS, group G2 (90) - VBAC attempt, and G2 to: G2a (35) - VBAC and G2b (55) - CS after an unsuccessful VB attempt. A comparative analysis between the groups and logistic regression analysis of factors influencing a successful VBAC was made...
2014: Neuro Endocrinology Letters
Natalie Whitelaw, Siladitya Bhattacharya, David McLernon, Mairead Black
BACKGROUND: Repeat caesarean sections make a substantial contribution to the overall caesarean section rate. It is important to understand what influences women to choose this option when the alternative of attempting vaginal birth after caesarean section is available. As many such women use the internet while seeking information on their options, the aim of this study was to assess content of websites on birth after previous caesarean and identify website characteristics which predict content...
2014: BMC Pregnancy and Childbirth
Kate Gardner, Amanda Henry, Steven Thou, Greg Davis, Trent Miller
BACKGROUND: Caesarean section rates in Australia have risen to >30%, with repeat caesarean delivery the most common indication. One method of reducing caesarean delivery rates is to increase rates of vaginal birth after caesarean section (VBAC). AIMS: To determine the combined effect of two management strategies on the rates of successful VBAC in women experiencing their first pregnancy following primary caesarean section. METHODS: Prospective cohort study from May 2009 to October 2010 at a metropolitan Australian teaching hospital...
August 2014: Australian & New Zealand Journal of Obstetrics & Gynaecology
George O Ugwu, Chukwuemeka A Iyoke, Hyacinth E Onah, Vincent E Egwuatu, Frank O Ezugwu
BACKGROUND: Obstetricians in developing countries appear generally reluctant to conduct vaginal delivery in women with a previous Cesarean because of lack of adequate facilities for optimal fetomaternal monitoring. OBJECTIVE: To describe delivery outcomes among women with one previous Cesarean section at a tertiary hospital in Southeast Nigeria. METHODS: This was a prospective observational study to determine maternal and perinatal outcomes of attempted vaginal birth after Cesarean sections (VBAC) following one previous Cesarean section...
2014: International Journal of Women's Health
Jawaria Farzand Raja, Kausar Tasneem Bangash, Ghazala Mahmud
OBJECTIVE: To develop a scoring system for the prediction of successful vaginal birth after caesarean section, following induction of labour with intra-vaginal E2 gel (Glandin). METHODS: The cross-sectional study was conducted from January 2010 to August 2011, at the Pakistan Institute of Medical Sciences in Islamabad. Trial of labour in previous one caesarean section, undergoing induction with intra-vaginal E2 gel, was attempted in 100 women. They were scored according to six variables; maternal age; gestation; indications of previous caesarean; history of vaginal birth either before or after the previous caesarean; Bishop score and body mass index...
September 2013: JPMA. the Journal of the Pakistan Medical Association
Jennifer A Tessmer-Tuck, Sherif A El-Nashar, Adrianne R Racek, Christine M Lohse, Abimbola O Famuyide, Myra J Wick
OBJECTIVE: To develop a model to predict vaginal birth after cesarean (VBAC) in our population and to compare the accuracy of this model to the accuracy of a previously published widely used model. MATERIALS AND METHODS: Women attempting trial of labor after cesarean delivery (TOLAC) at our institution from January 1, 2000 through May 30, 2010 were evaluated for inclusion. Demographic and clinical data were collected. Associations of these characteristics with VBAC were evaluated with univariate and multivariate logistic regression...
2014: Gynecologic and Obstetric Investigation
Jennifer A McKenna, Andrew G Symon
BACKGROUND: although Vaginal Birth After Caesarean section (VBAC) has been promoted successfully as one means of reducing the caesarean section rate, the practice of VBAC using water immersion (Water VBAC) is restricted. Very little valid, reliable research evidence is available on this birth method, although initial small-scale audits indicate that Water VBAC has no adverse effect on maternal and neonatal outcomes. METHOD: in-depth semi-structured interviews were carried out with a purposive sample of eight women who had undergone Water VBAC in one midwife-led unit...
January 2014: Midwifery
Saima Aziz Siddiqui
BACKGROUND AND OBJECTIVES: The trial of labor after previous cesarean (TOLAC) is an important strategy to limit repeat cesarean sections and their complications. An unsuccessful TOLAC leads to maternal and neonatal morbidities. The success or failure of TOLAC after the first cesarean is determinant for the subsequent vaginal birth. Limited studies are available from low-income countries, exclusively conducted in women in their sec.ond-order birth following the first cesarean section. This study aims at determining the frequency of unsuccessful attempts at vaginal delivery in the second-order term (37-41+6/7 weeks) birth among women with previous cesarean sections and to describe maternal and obstetric factors for unsuccessful laborTOLACs in the same group...
July 2013: Annals of Saudi Medicine
Caroline S E Homer, Karyn Besley, Jennifer Bell, Deborah Davis, Jon Adams, Alison Porteous, Maralyn Foureur
BACKGROUND: Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC...
2013: BMC Pregnancy and Childbirth
Aruyaru Stanley Mwenda
BACKGROUND: Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors. CASE PRESENTATION: A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4th stage of labour when omentum was noted protruding through the vagina...
2013: BMC Pregnancy and Childbirth
Nils Chaillet, Emmanuel Bujold, Eric Dubé, William A Grobman
BACKGROUND: Pregnant women with a previous Caesarean section face making the decision to undergo an elective repeat Caesarean section or to attempt a trial of labour with the goal of achieving a vaginal birth after Caesarean (VBAC). One of the key factors in counselling these women is the probability of a successful VBAC. We aimed to validate a prediction model for VBAC success. METHODS: We performed an analysis of women at term with one prior low-transverse Caesarean section and a live cephalic singleton pregnancy who attempted a trial of labour after Caesarean (TOLAC) at 32 hospitals in Quebec between 2008 and 2012...
February 2013: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
S Z Wanyonyi, A M Mukaindo, W Stones
BACKGROUND: The increasing Caesarean section rates being observed in most facilities will ultimately result in a larger proportion of women with previous scar. Choices need to be made by both the patient and the health worker between attempted Vaginal Birth after Caesarean section (VBAC) and Elective Repeat Caesarean section (ERCS). Both practices are associated with perinatal risks and benefits that call for certain objectivity and prudence in decision making especially where resources are scarce...
August 2010: East African Medical Journal
Roy Kessous, Dan Tirosh, Adi Y Weintraub, Neta Benshalom-Tirosh, Ruslan Sergienko, Eyal Sheiner
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...
June 2013: Archives of Gynecology and Obstetrics
Shiwu Wen, Yanfang Guo, Rihua Xie, Jessica Dy, Mark Walker
OBJECTIVE: A proportion of elective repeated cesarean sections where a trial of labor in a uterus with a previous scar was not attempted is on the increase. This study aimed to assess how reduced the use of trial of labor has impacted on neonatal outcomes in the United States. METHODS: Pregnant women with one previous cesarean delivery and a singleton live birth of the index pregnancy were abstracted from the 1995 to 2002 birth registration data of the United States...
November 2012: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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