Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean
Abstract Background Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of e...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-03-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-2833-2 |
| _version_ | 1818531708826288128 |
|---|---|
| author | Kaname Uno Michinori Mayama Masato Yoshihara Takehiko Takeda Sho Tano Teppei Suzuki Yasuyuki Kishigami Hidenori Oguchi |
| author_facet | Kaname Uno Michinori Mayama Masato Yoshihara Takehiko Takeda Sho Tano Teppei Suzuki Yasuyuki Kishigami Hidenori Oguchi |
| author_sort | Kaname Uno |
| collection | DOAJ |
| description | Abstract Background Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. To reveal the safety and feasibility of TOLAC, we conducted this observational, prospective study with women’s independent decisions. We aimed to clarify the relationship between their chosen mode of delivery and the reason for their previous Cesarean. Additionally, we have tried to identify maternal and obstetric factors associated with failed TOLAC to improve its success rate. Methods This was a prospective, observational study of 1086 pregnant women with at least one previous Cesarean delivery. Of these, 735 women met our TOLAC criteria (Table 1), and then, could choose TOLAC or repeat Cesarean after receiving detailed explanations regarding the risks and benefits of both procedures. The primary outcomes were the number of successful TOLAC procedures and 5-min Apgar scores < 7 for the trial of labor after Cesarean group and elective Cesarean group. We collected the maternal and neonatal data including the reasons of previous Cesarean. Results In total, 64.1% of women chose TOLAC. The success rate was 91.3%. The uterine rupture rate was 0.6%. There were no significant differences in the rate of Apgar scores at 5 min < 7 between both groups. Histories of experience of labor in previous Cesarean delivery were observed in 30 and 50% of women who chose TOLAC and repeat Cesarean, respectively (p < 0.05). Factors related to failed TOLAC included ≥40 weeks of gestation (odds: 5.47, 95% CI: 2.55–11.70) and prelabor rupture of membranes (PROM) (odds: 4.47, 95% CI: 2.07–9.63). Conclusions TOLAC is a favorable delivery option for both mothers and neonates when women meet criteria and choose after receiving detailed explanations. Women who experience PROM or ≥ 40 weeks of gestation, their modes of delivery should be reconsulted. |
| first_indexed | 2024-12-11T17:35:59Z |
| format | Article |
| id | doaj.art-ae83cbc743f84b96be70b390432ed05b |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-11T17:35:59Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-ae83cbc743f84b96be70b390432ed05b2022-12-22T00:56:41ZengBMCBMC Pregnancy and Childbirth1471-23932020-03-012011810.1186/s12884-020-2833-2Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after CesareanKaname Uno0Michinori Mayama1Masato Yoshihara2Takehiko Takeda3Sho Tano4Teppei Suzuki5Yasuyuki Kishigami6Hidenori Oguchi7Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalDepartment of Obstetrics, Perinatal Medical Center, TOYOTA Memorial HospitalAbstract Background Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. To reveal the safety and feasibility of TOLAC, we conducted this observational, prospective study with women’s independent decisions. We aimed to clarify the relationship between their chosen mode of delivery and the reason for their previous Cesarean. Additionally, we have tried to identify maternal and obstetric factors associated with failed TOLAC to improve its success rate. Methods This was a prospective, observational study of 1086 pregnant women with at least one previous Cesarean delivery. Of these, 735 women met our TOLAC criteria (Table 1), and then, could choose TOLAC or repeat Cesarean after receiving detailed explanations regarding the risks and benefits of both procedures. The primary outcomes were the number of successful TOLAC procedures and 5-min Apgar scores < 7 for the trial of labor after Cesarean group and elective Cesarean group. We collected the maternal and neonatal data including the reasons of previous Cesarean. Results In total, 64.1% of women chose TOLAC. The success rate was 91.3%. The uterine rupture rate was 0.6%. There were no significant differences in the rate of Apgar scores at 5 min < 7 between both groups. Histories of experience of labor in previous Cesarean delivery were observed in 30 and 50% of women who chose TOLAC and repeat Cesarean, respectively (p < 0.05). Factors related to failed TOLAC included ≥40 weeks of gestation (odds: 5.47, 95% CI: 2.55–11.70) and prelabor rupture of membranes (PROM) (odds: 4.47, 95% CI: 2.07–9.63). Conclusions TOLAC is a favorable delivery option for both mothers and neonates when women meet criteria and choose after receiving detailed explanations. Women who experience PROM or ≥ 40 weeks of gestation, their modes of delivery should be reconsulted.http://link.springer.com/article/10.1186/s12884-020-2833-2Trial of labor after cesarean (TOLAC)Elective repeat cesarean delivery (ERCD)Vaginal birth after cesarean (VBAC)Uterine rupturePrelabor rupture of membranes (PROM)women’s independent decision |
| spellingShingle | Kaname Uno Michinori Mayama Masato Yoshihara Takehiko Takeda Sho Tano Teppei Suzuki Yasuyuki Kishigami Hidenori Oguchi Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean BMC Pregnancy and Childbirth Trial of labor after cesarean (TOLAC) Elective repeat cesarean delivery (ERCD) Vaginal birth after cesarean (VBAC) Uterine rupture Prelabor rupture of membranes (PROM) women’s independent decision |
| title | Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean |
| title_full | Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean |
| title_fullStr | Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean |
| title_full_unstemmed | Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean |
| title_short | Reasons for previous Cesarean deliveries impact a woman’s independent decision of delivery mode and the success of trial of labor after Cesarean |
| title_sort | reasons for previous cesarean deliveries impact a woman s independent decision of delivery mode and the success of trial of labor after cesarean |
| topic | Trial of labor after cesarean (TOLAC) Elective repeat cesarean delivery (ERCD) Vaginal birth after cesarean (VBAC) Uterine rupture Prelabor rupture of membranes (PROM) women’s independent decision |
| url | http://link.springer.com/article/10.1186/s12884-020-2833-2 |
| work_keys_str_mv | AT kanameuno reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT michinorimayama reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT masatoyoshihara reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT takehikotakeda reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT shotano reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT teppeisuzuki reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT yasuyukikishigami reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean AT hidenorioguchi reasonsforpreviouscesareandeliveriesimpactawomansindependentdecisionofdeliverymodeandthesuccessoftrialoflaboraftercesarean |