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Anna Joy Rogers, Nathaniel G Rogers, Meredith L Kilgore, Akila Subramaniam, Lorie M Harper
BACKGROUND: For women who have had a previous low transverse cesarean delivery, the decision to undergo a trial of labor after cesarean (TOLAC) or an elective repeat cesarean delivery (ERCD) has important clinical and economic ramifications. OBJECTIVES: To evaluate the cost-effectiveness of the alternative choices of a TOLAC and an ERCD for women with low-risk, singleton gestation pregnancies. METHODS: We searched EMBASE, MEDLINE, CINAHL, Cochrane Library, EconLit, and the Cost-Effectiveness Analysis Registry with no language, publication, or date restrictions up until October 2015...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Moeun Son, Archana Roy, William A Grobman
BACKGROUND: It is not well characterized whether attempting operative vaginal delivery (OVD) is a safe and effective alternative among women undergoing a trial of labor after cesarean delivery (TOLAC) who are unable to complete second-stage labor with a spontaneous vaginal delivery. OBJECTIVE: To compare maternal and neonatal outcomes associated with attempted OVD to those associated with second-stage repeat cesarean delivery (RCD) without OVD attempt among women undergoing a TOLAC...
January 28, 2017: American Journal of Obstetrics and Gynecology
Clifton O Brock, Shravya Govindappagari, Cynthia Gyamfi-Bannerman
Objective The objective of this study is to determine the maternal and neonatal morbidity associated with attempting operative vaginal delivery (OVD) compared with the alternative of a laboring repeat cesarean delivery (LRCD) in women attempting a trial of labor after cesarean delivery (TOLAC). Methods This is a secondary analysis of a multicenter prospective study designed to assess perinatal outcomes of OVD in women with a prior uterine scar. The study includes women who attempted TOLAC and reached +2 station with a fully dilated cervix...
January 31, 2017: American Journal of Perinatology
Anne-Frederique Minsart, Hau Liu, Shannon Moffett, Crystal Chen, Ninni Ji
Recent studies show a steep rise in caesarean sections in China. Most couples are now eligible to apply for a second child. This retrospective cohort study compares the prevalence of trial of labour and vaginal birth after caesarean section among Chinese and foreign women in Shanghai. In total, 135 of 368 women underwent trial of labour (36.68%), and of those, 77 (57.04%) had a vaginal birth. After inclusion in a multivariate model, factors associated with trial of labour were maternal age <35 years with an adjusted odds ratio of 2...
December 28, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Anton Baranov, Eduard Gratacós, Olga Vikhareva, Francesc Figueras
OBJECTIVE: To validate the prediction model for successful vaginal birth after cesarean delivery (VBAC) based on variables easily obtainable at the first antenatal visit, in a Spanish population. METHODS: Retrospective observational study. Women with a single live fetus in cephalic presentation with one previous low-transverse CD who underwent trial of labor after cesarean delivery (TOLAC) at ≥37 gestational weeks between January 2011 and December 2015 were identified in the hospital's information system...
January 4, 2017: Journal of Maternal-fetal & Neonatal Medicine
Z Q Qu, R M Ma, H Xiao, Y Q Tian, B L Li, K Liang, M Y Du, Z Chen, L Geng, M H Yang, Y P Tao, B Zhu
Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. The maternal and neonatal outcomes among the vaginal birth after cesarean(VBAC)group(481 cases), failed TOLAC group(105 cases)and the elective repeat cesarean section(ERCS)group(1 145 cases)were compared...
October 25, 2016: Zhonghua Fu Chan Ke za Zhi
Sonya Charles, Allison B Wolf
In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section (TOLAC). Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values (i.e. what level of risk are you comfortable with or what types of risks are you willing to take) rather than medical data (or at least medical data alone)...
October 20, 2016: Journal of Medical Humanities
Elie Nkwabong, Joseph Nelson Fomulu, Fabrice Lionel Djomkam Youmsi
OBJECTIVE: To evaluate outcome of trial of labor after cesarean section (TOLAC) with fetal weight >3500 g. MATERIALS AND METHODS: This retrospective descriptive study was carried out between March 1, 2012, and February 28, 2015. Medical and obstetrical records of women with birth weight (BW) >3500 g admitted in the labor ward with advanced labor or admitted in early labor but with underestimated fetal weight >3500 g were analyzed. Main variables analyzed included maternal parity, vaginal delivery prior to TOLAC, the BW and the integrity of the uterine scar...
October 2016: Journal of Obstetrics and Gynaecology of India
Patricia Bellows, Utsavi Shah, Lauren Hawley, Kathleen Drexler, Manisha Gandhi, Haleh Sangi-Haghpeykar, Christina Davidson
OBJECTIVE: To evaluate maternal-neonatal morbidity for women undergoing trial of labor after cesarean (TOLAC) following clinical practice changes based upon ACOG's 2010 VBAC guideline. STUDY DESIGN: Four-year retrospective cohort analysis around implementation of a hospital guideline in women undergoing TOLAC with a live, cephalic, singleton without lethal anomaly ≥24 weeks and ≥1 prior cesarean. Maternal-neonatal outcomes pre- and post-guideline implementation were compared...
October 16, 2016: Journal of Maternal-fetal & Neonatal Medicine
Lynn M Yee, Lilly Y Liu, William A Grobman
BACKGROUND: Reducing cesarean deliveries is a major public health goal. The low rate of vaginal birth after cesarean has been attributed largely to a decrease in the likelihood of choosing a trial of labor after cesarean, despite evidence suggesting a majority of women with 1 prior low transverse cesarean are trial of labor after cesarean candidates. Although a number of reasons for this decrease have been explored, it remains unclear how systems issues such as physician call schedules influence delivery approach and mode in this context...
January 2017: American Journal of Obstetrics and Gynecology
L He, M Chen, G L He, X X Liu
OBJECTIVE: To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). METHODS: From January 2005 to December 2015, clinical data of 507 cases with VBAC in West China Second Hospital were studied retrospectively. There were 370 cases of VBAC from January 2013 to December 2015 as study group (VBAC group), in contrast, 740 cases of elective repeat cesarean section (ERCS group) and 740 primiparas of vaginal delivery without history of cesarean section as control groups, the pregnancy outcome were analyzed between the study group and control groups respectively...
August 25, 2016: Zhonghua Fu Chan Ke za Zhi
L Yu, C H Su, X Y Wang, J J Gong, P Chen, H M Du, Q H Quan, L L Li, D J Chen
OBJECTIVE: To study the feasibility and safety of trial of labor after cesarean section (TOLAC). METHODS: Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC. RESULTS: (1) During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13...
August 25, 2016: Zhonghua Fu Chan Ke za Zhi
S W Wu, Y Z Lu, S S Wang, X J Dong, J H Fang, D He, W Y Zhang
OBJECTIVE: To investigate the factors affecting the vaginal birth after cesarean (VBAC). METHODS: Totaly 298 women who underwent trial of labor after cesarean section (TOLAC) from Jan 2015 to Dec 2015 were recruited from Beijing Obstetrics and Gynecology Hospital, FuXing Hospital, Tongzhou Maternal and Child Health Hospital of Beijing, the Second Affiliated Hospital of Chongqing Medical University and the People's Hospital of Chengyang District of Qingdao. The maternal age, the interval from the last cesarean section, the body mass index (BMI) before pregnancy, the weight gain during pregnancy, the way into labor, the Bishop score before labor, the gestational age and the birth weight of the neonate were recorded in a self-made form...
August 25, 2016: Zhonghua Fu Chan Ke za Zhi
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
Somphit Chinkam, Jean Ewan, Rebecca Koeniger-Donohue, Joellen W Hawkins, Allison Shorten
INTRODUCTION: The purpose of this study was to evaluate how a scripted counseling intervention affected the experience of decision making and actual choice for trial of labor after cesarean (TOLAC) or elective repeat cesarean birth (ERCB) in a cohort of women receiving care from nurse-midwives. METHODS: A pilot study of scripted counseling for women who had a previous cesarean about TOLAC versus ERCB was conducted at Boston Medical Center. Candidates for a TOLAC, receiving prenatal care from nurse-midwives in 2012 and 2013, were enrolled before 28 weeks' gestation...
July 18, 2016: Journal of Midwifery & Women's Health
Wai-Hou Li, Ming-Jie Yang, Peng-Hui Wang, Chi-Mou Juang, Yi-Wen Chang, Hsing-I Wang, Chih-Yao Chen, Ming-Shyen Yen
OBJECTIVE: Because of the increased risk of uterine rupture and other morbidities, instances of trial of labor after cesarean (TOLAC) have decreased in number each year. Nevertheless, under careful assessment and advanced medical care, TOLAC is still a safe option for delivery. The objective of this study is to find the factors that impact the success rate for TOLAC and to compare the results with Taiwan national registry data. MATERIALS AND METHODS: A longitudinal cohort study that includes a total of 254 cases of women receiving TOLAC in a tertiary medical center over a period of 10 years...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
Utsavi Shah, Patricia Bellows, Kathleen Drexler, Lauren Hawley, Christina Davidson, Haleh Sangi-Haghpeykar, Manisha Gandhi
OBJECTIVE: To compare induction of labor methods in patients attempting a trial of labor after cesarean (TOLAC) with an unfavorable cervix. METHODS: This is a retrospective cohort study from patients attempting TOLAC from 2009 to 2013. Patients with a simplified Bishop score of three or less where labor was initiated with either a Cook balloon or oxytocin were included. Our primary outcome was mode of delivery. Our secondary outcomes included duration of labor and multiple maternal and neonatal morbidities...
June 29, 2016: Journal of Maternal-fetal & Neonatal Medicine
Mark B Landon, William A Grobman
The cesarean delivery rate in the United States has risen steadily over the past 5 decades such that approximately one in three women now undergo cesarean section. The rise in repeat operations and accompanying decline in trial of labor after cesarean (TOLAC) have been major contributors to this phenomenon. The appropriate use of TOLAC continues to be a topic of interest with the recognition that most women with a history of prior cesarean are candidates for trial of labor. The NICHD MFMU Network Cesarean Registry conducted from 1999 to 2002 provided contemporary data concerning the risks and benefits of TOLAC, which in turn have helped inform practitioners and women considering their options for childbirth following cesarean delivery...
August 2016: Seminars in Perinatology
G Vandenberghe, M De Blaere, V Van Leeuw, K Roelens, Y Englert, M Hanssens, H Verstraelen
OBJECTIVES: We aimed to assess the prevalence of uterine rupture in Belgium and to evaluate risk factors, management and outcomes for mother and child. DESIGN: Nationwide population-based prospective cohort study. SETTING: Emergency obstetric care. Participation of 97% of maternity units covering 98.6% of the deliveries in Belgium. PARTICIPANTS: All women with uterine rupture in Belgium between January 2012 and December 2013...
2016: BMJ Open
S Bartolo, F Goffinet, B Blondel, C Deneux-Tharaux
OBJECTIVE: To identify the characteristics of women and maternity units associated with elective repeat caesarean delivery (ERCD) in women eligible for trial of labour after caesarean (TOLAC). DESIGN: Cross-sectional study. SETTING: France. POPULATION AND SAMPLE: Using data from the 2010 French National Perinatal Survey, a representative sample of births in France (n = 14 681 women), we studied two groups of women with prior caesarean section: (i) women eligible for TOLAC according to guidelines (n = 1179) and (ii) a subgroup of these women without any medical characteristics that might indicate ERCD (n = 575)...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
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