Trial of labor after one previous cesarean delivery for multifetal gestation

Michael W. Varner; Elizabeth Thom; Catherine Y. Spong; Mark B. Landon; Kenneth J. Leveno; Dwight J. Rouse; Atef H. Moawad; Hyagriv N. Simhan; Margaret Harper; Ronald J. Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan Peaceman; Mary J. O'Sullivan; Baha M. Sibai; Oded Langer; John M. Thorp; Susan M. Ramin; Brian M. Mercer

doi:10.1097/01.AOG.0000280586.05350.9e

Trial of labor after one previous cesarean delivery for multifetal gestation

Michael W. Varner, Elizabeth Thom, Catherine Y. Spong, Mark B. Landon, Kenneth J. Leveno, Dwight J. Rouse, Atef H. Moawad, Hyagriv N. Simhan, Margaret Harper, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Susan M. Ramin, Brian M. Mercer

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

OBJECTIVE: To estimate success rates and risks with a trial of labor after one previous cesarean delivery for multifetal gestation compared with one previous cesarean delivery for a singleton pregnancy. METHODS: Patients from the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network Cesarean Registry with one previous cesarean delivery and a current term singleton pregnancy were identified. Cases had one previous cesarean delivery for a multifetal pregnancy. Controls had one previous cesarean delivery for a singleton pregnancy. RESULTS: Of cases, 556 of 944 (58.9%) attempted a trial of labor. Of controls, 13,923 of 29,329 (47.5%) attempted a trial of labor. The trial of labor success rate was 85.6% among cases and 73.1% among controls (odds ratio 2.19, 95% confidence interval 1.72-2.78). Compared with trial of labor controls, cases had no statistically increased risk of transfusion, endometritis, intensive care unit admissions, uterine rupture, or perinatal complications. Cases in this analysis with a successful trial of labor were more likely to have previously had a successful vaginal birth after cesarean (37.1% compared with 14.1%, P<.001). CONCLUSION: Women with one previous cesarean delivery for a multifetal gestation have high trial of labor success rates and low complication rates.

Original language	English (US)
Pages (from-to)	814-819
Number of pages	6
Journal	Obstetrics and gynecology
Volume	110
Issue number	4
DOIs	https://doi.org/10.1097/01.AOG.0000280586.05350.9e
State	Published - Oct 2007

ASJC Scopus subject areas

Obstetrics and Gynecology

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Varner, M. W., Thom, E., Spong, C. Y., Landon, M. B., Leveno, K. J., Rouse, D. J., Moawad, A. H., Simhan, H. N., Harper, M., Wapner, R. J., Sorokin, Y., Miodovnik, M., Carpenter, M., Peaceman, A., O'Sullivan, M. J., Sibai, B. M., Langer, O., Thorp, J. M., Ramin, S. M., & Mercer, B. M. (2007). Trial of labor after one previous cesarean delivery for multifetal gestation. Obstetrics and gynecology, 110(4), 814-819. https://doi.org/10.1097/01.AOG.0000280586.05350.9e

Varner, MW, Thom, E, Spong, CY, Landon, MB, Leveno, KJ, Rouse, DJ, Moawad, AH, Simhan, HN, Harper, M, Wapner, RJ, Sorokin, Y, Miodovnik, M, Carpenter, M, Peaceman, A, O'Sullivan, MJ, Sibai, BM, Langer, O, Thorp, JM, Ramin, SM & Mercer, BM 2007, 'Trial of labor after one previous cesarean delivery for multifetal gestation', Obstetrics and gynecology, vol. 110, no. 4, pp. 814-819. https://doi.org/10.1097/01.AOG.0000280586.05350.9e

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title = "Trial of labor after one previous cesarean delivery for multifetal gestation",

abstract = "OBJECTIVE: To estimate success rates and risks with a trial of labor after one previous cesarean delivery for multifetal gestation compared with one previous cesarean delivery for a singleton pregnancy. METHODS: Patients from the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network Cesarean Registry with one previous cesarean delivery and a current term singleton pregnancy were identified. Cases had one previous cesarean delivery for a multifetal pregnancy. Controls had one previous cesarean delivery for a singleton pregnancy. RESULTS: Of cases, 556 of 944 (58.9%) attempted a trial of labor. Of controls, 13,923 of 29,329 (47.5%) attempted a trial of labor. The trial of labor success rate was 85.6% among cases and 73.1% among controls (odds ratio 2.19, 95% confidence interval 1.72-2.78). Compared with trial of labor controls, cases had no statistically increased risk of transfusion, endometritis, intensive care unit admissions, uterine rupture, or perinatal complications. Cases in this analysis with a successful trial of labor were more likely to have previously had a successful vaginal birth after cesarean (37.1% compared with 14.1%, P<.001). CONCLUSION: Women with one previous cesarean delivery for a multifetal gestation have high trial of labor success rates and low complication rates.",

author = "Varner, {Michael W.} and Elizabeth Thom and Spong, {Catherine Y.} and Landon, {Mark B.} and Leveno, {Kenneth J.} and Rouse, {Dwight J.} and Moawad, {Atef H.} and Simhan, {Hyagriv N.} and Margaret Harper and Wapner, {Ronald J.} and Yoram Sorokin and Menachem Miodovnik and Marshall Carpenter and Alan Peaceman and O'Sullivan, {Mary J.} and Sibai, {Baha M.} and Oded Langer and Thorp, {John M.} and Ramin, {Susan M.} and Mercer, {Brian M.}",

year = "2007",

month = oct,

doi = "10.1097/01.AOG.0000280586.05350.9e",

language = "English (US)",

volume = "110",

pages = "814--819",

journal = "Obstetrics and gynecology",

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T1 - Trial of labor after one previous cesarean delivery for multifetal gestation

AU - Varner, Michael W.

AU - Thom, Elizabeth

AU - Spong, Catherine Y.

AU - Landon, Mark B.

AU - Leveno, Kenneth J.

AU - Rouse, Dwight J.

AU - Moawad, Atef H.

AU - Simhan, Hyagriv N.

AU - Harper, Margaret

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Miodovnik, Menachem

AU - Carpenter, Marshall

AU - Peaceman, Alan

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Mercer, Brian M.

PY - 2007/10

Y1 - 2007/10

N2 - OBJECTIVE: To estimate success rates and risks with a trial of labor after one previous cesarean delivery for multifetal gestation compared with one previous cesarean delivery for a singleton pregnancy. METHODS: Patients from the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network Cesarean Registry with one previous cesarean delivery and a current term singleton pregnancy were identified. Cases had one previous cesarean delivery for a multifetal pregnancy. Controls had one previous cesarean delivery for a singleton pregnancy. RESULTS: Of cases, 556 of 944 (58.9%) attempted a trial of labor. Of controls, 13,923 of 29,329 (47.5%) attempted a trial of labor. The trial of labor success rate was 85.6% among cases and 73.1% among controls (odds ratio 2.19, 95% confidence interval 1.72-2.78). Compared with trial of labor controls, cases had no statistically increased risk of transfusion, endometritis, intensive care unit admissions, uterine rupture, or perinatal complications. Cases in this analysis with a successful trial of labor were more likely to have previously had a successful vaginal birth after cesarean (37.1% compared with 14.1%, P<.001). CONCLUSION: Women with one previous cesarean delivery for a multifetal gestation have high trial of labor success rates and low complication rates.

AB - OBJECTIVE: To estimate success rates and risks with a trial of labor after one previous cesarean delivery for multifetal gestation compared with one previous cesarean delivery for a singleton pregnancy. METHODS: Patients from the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network Cesarean Registry with one previous cesarean delivery and a current term singleton pregnancy were identified. Cases had one previous cesarean delivery for a multifetal pregnancy. Controls had one previous cesarean delivery for a singleton pregnancy. RESULTS: Of cases, 556 of 944 (58.9%) attempted a trial of labor. Of controls, 13,923 of 29,329 (47.5%) attempted a trial of labor. The trial of labor success rate was 85.6% among cases and 73.1% among controls (odds ratio 2.19, 95% confidence interval 1.72-2.78). Compared with trial of labor controls, cases had no statistically increased risk of transfusion, endometritis, intensive care unit admissions, uterine rupture, or perinatal complications. Cases in this analysis with a successful trial of labor were more likely to have previously had a successful vaginal birth after cesarean (37.1% compared with 14.1%, P<.001). CONCLUSION: Women with one previous cesarean delivery for a multifetal gestation have high trial of labor success rates and low complication rates.

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JF - Obstetrics and gynecology

IS - 4

ER -

Trial of labor after one previous cesarean delivery for multifetal gestation

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