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Induction of labor after a prior cesarean delivery: lessons from a population-based study
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Lea Shatz
Published/Copyright:
September 4, 2012
Abstract
Objectives: The aims of this study were (1) to determine the success rate of induction of labor (IOL) in women with a prior cesarean section (CS) and (2) to compare the perinatal outcome of a trial of labor (TOL) in women with one prior CS who had an IOL, spontaneous onset of labor, or an elective repeated CS (ERCS).
Material and methods: This study population was divided into three groups: women who had (1) ERCS (n=1916), (2) spontaneous TOL (n=4263), and (3) IOL (n=1576).
Results: (1) The rate of IOL in the study cohort was 20.3%; of these, 67.4% had a successful vaginal birth after cesarean (VBAC). (2) Patients in the spontaneous TOL group had a higher VBAC rate than did those who had IOL (P<0.001). (3) The rate of uterine rupture was comparable among all study groups. And (4) a prior vaginal birth increased the likelihood of having a successful induction and a VBAC by 50%.
Conclusion: IOL in patients with a previous CS is successful in about two-thirds of the cases. Induction is a safe and useful tool that can serve as an alternative for ERCS and assist to reduce the rate of ERCS.
Keywords: Uterine rupture; dehiscence; endometritis; hypoxic ischemic encephalopathy; trial of labor; dystocia
Received: 2012-5-11
Revised: 2012-7-8
Accepted: 2012-7-30
Published Online: 2012-09-04
Published in Print: 2013-03-01
©2013 by Walter de Gruyter Berlin Boston
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Keywords for this article
Uterine rupture;
dehiscence;
endometritis;
hypoxic ischemic encephalopathy;
trial of labor;
dystocia
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