ABSTRACT
The purpose of this study was to compare the outcome and cumulative morbidity among
women who delivered twice after a cesarean delivery (CD), and who underwent in the
second delivery either a trial of labor (TOL) or planned cesarean delivery (PCD).
Eligible women (N = 399) were divided into two groups based on first post-CD: a TOL
(n = 304) or PCD (n = 95). Women attempting a TOL were successful in 70 and 75% in
the first and second post-CD, respectively. All participants undergoing a PCD subsequently
had a third PCD. The overall morbidity was 8.4 and 5.3% among PCD and TOL groups,
respectively (p = 0.258). Women attempting a TOL after a previous CD had a 70 and 53% likelihood
for at least one successful or two successful vaginal births in the two subsequent
deliveries, respectively. No significant difference was documented between the groups
regarding the cumulative morbidity.
KEYWORDS
Planned cesarean delivery - trial of labor after cesarean - repeated cesarean delivery
- morbidity
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Ron GonenM.D.
Deputy Chairman, Department of Obstetrics & Gynecology, Director of Maternal-Fetal
Medicine, Bnai Zion Medical Center
47 Golomb Street, Haifa, Israel