Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
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Olivier Sibony
Abstract
Objective: To examine whether X-ray pelvimetry data to evaluate the likelihood of vaginal birth after previous cesarean section.
Design: Retrospective study
Setting: University hospital
Population: Patients with a previous cesarean delivery who underwent X-ray pelvimetry and gave birth at gestational age 37 weeks during a seven-year period.
Methods: 1190 patients with a scarred uterus were compared with 15,189 patients without a scarred uterus. In the scarred uterus group, 760 patients with a transverse pelvic diameter ≥12 cm were compared with 430 patients with a transverse pelvic diameter <12 cm.
Main outcome measures: The obstetrical outcomes were spontaneous or induced labor, and mode of delivery. The maternal morbidity outcomes were hemorrhage requiring transfusion of packed red cells, uterine rupture, bladder injury, and hysterectomy due to hemorrhage. The neonatal morbidity outcomes were the 5-min Apgar score, transfer to intensive care, and intubation.
Results: Patients with a scarred uterus had a significantly higher rate of cesarean section (35.5%) than those with no prior cesarean section (9%). Among patients with a scarred uterus who were selected for vaginal delivery, 81% delivered vaginally when the transverse diameter (TD) of the pelvic inlet was greater than 12 cm, 68% when the TD was between 11.5 and 12 cm, and 58% when the TD was less than 11.5 cm. Maternal morbidity was significantly higher in the patients with a scarred uterus. The neonatal results were comparable in the different groups.
Conclusion: X-ray pelvimetry tailors the information given to each patient about the likelihood of having a vaginal delivery. It can also be used to optimize the selection of patients allowed to enter labor.
References
1 Flamm BL, LA Newman, SJ Thomas, D Fallon, MM Yoshida: Vaginal birth after cesarean section: results of 5-year multicenter collaborative study. Obstet Gynecol76 (1990) 750Suche in Google Scholar
2 Guise JM, M Berlin, M Mc Donagh, P Osterweil, B Chan, M Helfand: Safety of vaginal birth after cesarean: a systematic review. Obstet Gynecol103 (2004) 420Suche in Google Scholar
3 Langer B, G Schlaeder: Que penser du taux de césarienne en France? J Gynecol Obstet Biol Reprod27 (1998) 62Suche in Google Scholar
4 Lydon-Rochelle M, V Holt, T Easterling, P Diane: Risk of uterine rupture during labor among women with a prior cesarean delivery. N Engl J Med345 (2001) 3Suche in Google Scholar
5 MacMahon M, E Luther, W Bowes, A Olshan: Comparison of a trial of labor with an elective second cesarean section. N Engl J Med335 (1996) 689Suche in Google Scholar
6 Morzukewih E, E Hutton: Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol183 (2000) 1187Suche in Google Scholar
7 Ofir K, E Sheiner, A Levy, M Katz, M Mazor: Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol189 (2003) 1042Suche in Google Scholar
8 Phelan JP, SL Clark, F Diaz, RH Paul: Vaginal birth after cesarean section. Am J Obstet Gynecol157 (1987) 1510Suche in Google Scholar
9 Ravasia D, S Wood, J Pollard: Uterine rupture during induced trial of labor among women with previous cesarean delivery. Am J Obstet Gynecol183 (2000) 1176Suche in Google Scholar
10 Rosen MG, JC Dickenson, CL Westhoff: Vaginal birth after cesarean: a meta-analysis of morbidity and mortality. Obstet Gynecol77 (1991) 465Suche in Google Scholar
11 Smith G, J Pell, R Dobbie: Cesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 362(9398) (2003) 1779Suche in Google Scholar
12 Thubisi M, A Ebrahim, J Moodley, PM Shweni: Vaginal delivery after previous cesarean section: is X-ray pelvimetry necessary? Br J Obstet Gynaecol100 (1993) 421Suche in Google Scholar
©2006 by Walter de Gruyter Berlin New York
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- The chemical erosion of human health: adverse environmental exposure and in-utero pollution – determinants of congenital disorders and chronic disease
- Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?
- Antibiotic therapy for preterm premature rupture of membranes – results of a multicenter study
- Relation between grief and subsequent pregnancy status 13 months after perinatal bereavement
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Dilatation of the abdominal umbilical vein is associated with increased risk of thrombotic complications
- Retrospective diagnosis of hypoxic myocardial injury in premature newborns
- Fetal brain injury in experimental intrauterine asphyxia and inflammation in Göttingen minipigs
- Intrauterine growth restriction induces increased capillary density and accelerated type I fiber maturation in newborn pig skeletal muscles
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- Resolution of peripheral tissue ischemia secondary to arterial vasospasm following treatment with a topical nitroglycerin device in two newborns: case reports
- Echocardiography and N-terminal pro BNP
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