Mode of delivery in women with antepartum fetal death and prior cesarean delivery

Mildred M. Ramirez, Sharon Gilbert, Mark B. Landon, Dwight J. Rouse, Catherine Y. Spong, Michael W. Varner, Steve N. Caritis, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan M. Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Brian M. Mercer

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD ≥ 20 weeks' gestation or 500 g were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age±standard deviation at delivery was 31.3±6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases.

Original languageEnglish (US)
Pages (from-to)825-829
Number of pages5
JournalAmerican Journal of Perinatology
Volume27
Issue number10
DOIs
StatePublished - 2010

Keywords

  • Vaginal birth after cesarean
  • fetal demise
  • induction of labor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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