RSS-Feed abonnieren
DOI: 10.1055/s-0038-1670679
Gestational Weight Gain during Pregnancy as an Important Factor Influencing a Successful Trial of Labor following Two Previous Cesareans
Funding None.Publikationsverlauf
28. Januar 2018
13. August 2018
Publikationsdatum:
19. September 2018 (online)
Abstract
Objective We sought to identify factors associated with a successful trial of labor (TOL) following two cesarean deliveries (CDs) in a contemporary North American cohort.
Study Design This is a retrospective cohort study of term, nonanomalous, singleton, vertex pregnancies attempting a vaginal birth after cesarean (VBAC) following a history of two previous CDs in the United States from 2012 to 2014. Maternal and intrapartum factors were analyzed using chi-square tests and multivariable logistic regression.
Results A total of 22,762 women met the inclusion criteria and underwent TOL. Of these, 12,192 (53.6%) had a VBAC. Using multivariate logistic regression, previous vaginal delivery and delivery at 40 to 41 weeks' gestation were associated with VBAC; maternal age, education, Medicaid insurance, non-Caucasian race/ethnicity, weight (overweight or obese), and gestational weight gain above the Institute of Medicine guidelines (adjusted odds ratio: 0.88; 95% confidence interval: 0.81–0.95) were associated with CD. Induction of labor did not affect the VBAC rate.
Conclusion For those desiring a TOL after two previous CDs, prospective studies are needed to assess interventions that limit gestational weight gain as well as the safety and optimal timing of an induction of labor. The decision to attempt a TOL should be guided by counseling regarding the risks, benefits, and chances of a successful TOL.
Keywords
maternal and fetal morbidity - TOLAC - trial of labor after two cesareans - vaginal birth after cesarean - VBACNote
This study was presented as a poster presentation at the 37th Annual Meeting of the Society for Maternal-Fetal Medicine, Las Vegas, NV, January 27, 2017.
-
References
- 1 Hamilton BE, Martin JA, Osterman MJK, Curtin SC, Matthews TJ. Births: final data for 2014. Natl Vital Stat Rep 2015; 64 (12) 1-64
- 2 Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep 2017; 66 (01) 1
- 3 Lydon-Rochelle MT, Cahill AG, Spong CY. Birth after previous cesarean delivery: short-term maternal outcomes. Semin Perinatol 2010; 34 (04) 249-257
- 4 Silver RM. Delivery after previous cesarean: long-term maternal outcomes. Semin Perinatol 2010; 34 (04) 258-266
- 5 Guise J-M, Eden K, Emeis C. , et al. Vaginal Birth after Cesarean: New Insights. Evidence report/technology assessment no. 191 (prepared by the Oregon Health & Science University Evidence-based Practice Center under Contract No. 290–2007–10057-I). AHRQ Publication No. 10–E003. Rockville, MD: Agency for Healthcare Research and Quality; 2010
- 6 Silver RM, Landon MB, Rouse DJ. , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006; 107 (06) 1226-1232
- 7 Cahill AG, Tuuli M, Odibo AO, Stamilio DM, Macones GA. Vaginal birth after caesarean for women with three or more prior caesareans: assessing safety and success. BJOG 2010; 117 (04) 422-427
- 8 Sadan O, Leshno M, Gottreich A, Golan A, Lurie S. Once a cesarean always a cesarean? A computer-assisted decision analysis. Arch Gynecol Obstet 2007; 276 (05) 517-521
- 9 Gilbert SA, Grobman WA, Landon MB. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Cost-effectiveness of trial of labor after previous cesarean in a minimally biased cohort. Am J Perinatol 2013; 30 (01) 11-20
- 10 Wymen KM, SXhih YC, Plunkett BA. The cost-effectiveness of a trial of labor accrues with multiple subsequent vaginal deliveries. Am J Obstet Gynecol 2014; 211 (01) 56.e1-56.e12
- 11 American College of Obstetricians and Gynecologists: Practice Bulletin 115 Vaginal Birth after Previous Cesarean Delivery. Washington, DC ACOG; 2010 (reaffirmed 2015)
- 12 Barger MK, Dunn JT, Bearman S, DeLain M, Gates E. A survey of access to trial of labor in California hospitals in 2012. BMC Pregnancy Childbirth 2013; 13: 83
- 13 Leeman LM, Beagle M, Espey E, Ogburn T, Skipper B. Diminishing availability of trial of labor after cesarean delivery in New Mexico hospitals. Obstet Gynecol 2013; 122 (2 Pt 1): 242-247
- 14 Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010; 117 (01) 5-19
- 15 Yaman Tunc S, Agacayak E, Sak S. , et al. Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?. J Matern Fetal Neonatal Med 2017; 30 (06) 739-744
- 16 Metz TD, Allshouse AA, Faucett AM, Grobman WA. Validation of a vaginal birth after cesarean delivery prediction model in women with two prior cesarean deliveries. Obstet Gynecol 2015; 125 (04) 948-952
- 17 Bonanno C, Clausing M, Berkowitz R. VBAC: a medicolegal perspective. Clin Perinatol 2011; 38 (02) 217-225
- 18 Daugherty J, Martinez G. Birth expectations of US women aged 15–44. NCHS Data Brief 2016; (260) 1-8
- 19 Hendler I, Bujold E. Effect of prior vaginal delivery or prior vaginal birth after cesarean delivery on obstetric outcomes in women undergoing trial of labor. Obstet Gynecol 2004; 104 (02) 273-277
- 20 Palatnik A, Grobman WA. Induction of labor versus expectant management for women with a prior cesarean delivery. Am J Obstet Gynecol 2015; 212 (03) 358.e1-358.e6
- 21 Lappen JR, Hackney DN, Bailit JL. Outcomes of term induction in trial of labor after cesarean delivery. Obstet Gynecol 2015; 126 (01) 115-123
- 22 Macones GA, Cahill A, Pare E. , et al. Obstetric outcomes in women with two prior cesarean deliveries: is vaginal birth after cesarean delivery a viable option?. Am J Obstet Gynecol 2005; 192 (04) 1223-1228