Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success
Objective: Determining the appropriate approach for delivery after previous cesarean is a very controversial issue. Our objective was to establish whether pregnant women with a previous cesarean have an increased maternal and fetal morbidity and mortality after attempting vaginal delivery as well as...
| Authors: | ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2023 |
| Country: | España |
| Institution: | Universidad de Sevilla (US) |
| Repository: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/177981 |
| Online Access: | https://hdl.handle.net/11441/177981 https://doi.org/10.24875/RECHOG.22000080 |
| Access Level: | Open access |
| Keyword: | Vaginal births after cesarean Repeat cesarean section Maternal mortality Neonatal mortality Obstetric delivery Parto vaginal tras cesárea Cesárea anterior Mortalidad materna Mortalidad neonatal Parto obstétrico |
| _version_ | 1878733016473272320 |
|---|---|
| author | García Jiménez, Rocío |
| author2 | Valero, Irene Weber Fernández, Ana María Florez, Natalia Martínez Aguado, Irene Borrero González, Carlota |
| author2_role | author author author author author |
| author_browse | Borrero González, Carlota Florez, Natalia García Jiménez, Rocío Martínez Aguado, Irene Valero, Irene Weber Fernández, Ana María |
| author_facet | García Jiménez, Rocío Valero, Irene Weber Fernández, Ana María Florez, Natalia Martínez Aguado, Irene Borrero González, Carlota |
| author_role | author |
| collection | idUS. Depósito de Investigación de la Universidad de Sevilla |
| description | Objective: Determining the appropriate approach for delivery after previous cesarean is a very controversial issue. Our objective was to establish whether pregnant women with a previous cesarean have an increased maternal and fetal morbidity and mortality after attempting vaginal delivery as well as to determine which factors may influence the achievement of a vaginal birth after cesarean. Materials and methods: A retrospective observational cohort study including 390 patients (196 cesarean group and 194 nulliparous group) was carried out. We compared neonatal and maternal outcomes between groups. Afterward, a multivariate logistic regression was applied for our second objective. Results: There were higher rates of uterine rupture (2% vs. 0%, p: 0.045) and puerperal hemorrhage (9.7% vs. 3.1%, p: 0.008) in the cesarean group and lower vaginal delivery rate (58.2% vs. 77.8%, p < 0.0005). We found that the induced onset of labor (OR = 2.9) and new born weight (OR = 1.0001) were associated with an increased risk of cesarean section. Conclusions: Our findings stress the need for further investigations in this field, which might provide a basis for a better management of patients with a previous cesarean. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_4e692e291a5f4a4faa77491efc2a4efa |
| institution | Universidad de Sevilla (US) |
| instname_str | Universidad de Sevilla (US) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:idus.us.es:11441/177981 |
| publishDate | 2023 |
| publishDateSort | 2023 |
| publisher | Sociedad Chilena de Obstetricia y Ginecologia |
| publisherStr | Sociedad Chilena de Obstetricia y Ginecologia |
| reponame_str | idUS. Depósito de Investigación de la Universidad de Sevilla |
| spelling | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success Parto tras cesárea anterior: análisis de la morbimortalidad materno-fetal García Jiménez, Rocío Valero, Irene Weber Fernández, Ana María Florez, Natalia Martínez Aguado, Irene Borrero González, Carlota Vaginal births after cesarean Repeat cesarean section Maternal mortality Neonatal mortality Obstetric delivery Parto vaginal tras cesárea Cesárea anterior Mortalidad materna Mortalidad neonatal Parto obstétrico Objective: Determining the appropriate approach for delivery after previous cesarean is a very controversial issue. Our objective was to establish whether pregnant women with a previous cesarean have an increased maternal and fetal morbidity and mortality after attempting vaginal delivery as well as to determine which factors may influence the achievement of a vaginal birth after cesarean. Materials and methods: A retrospective observational cohort study including 390 patients (196 cesarean group and 194 nulliparous group) was carried out. We compared neonatal and maternal outcomes between groups. Afterward, a multivariate logistic regression was applied for our second objective. Results: There were higher rates of uterine rupture (2% vs. 0%, p: 0.045) and puerperal hemorrhage (9.7% vs. 3.1%, p: 0.008) in the cesarean group and lower vaginal delivery rate (58.2% vs. 77.8%, p < 0.0005). We found that the induced onset of labor (OR = 2.9) and new born weight (OR = 1.0001) were associated with an increased risk of cesarean section. Conclusions: Our findings stress the need for further investigations in this field, which might provide a basis for a better management of patients with a previous cesarean. Objetivo: Determinar el abordaje adecuado del tipo de parto tras una cesárea previa es un tema muy controvertido. Nuestro objetivo fue establecer si las gestantes con cesárea previa presentan mayor morbimortalidad materna y fetal tras intentar parto vaginal, así como determinar qué factores pueden influir en conseguir un parto vaginal posterior a la cesárea. Material y métodos: Estudio observacional de cohortes retrospectivo incluyendo 390 pacientes (196 con cesárea previa, 194 nulíparas). Comparamos los datos sobre los resultados neonatales y maternos. Posteriormente se aplicó un modelo de regresión logística multivariante. Resultados: Hubo mayores tasas de ruptura uterina (2% vs. 0%; p = 0.045) y hemorragia puerperal (9.7% vs. 3.1%, p: 0.008) en el grupo de cesárea anterior, así como una tasa de parto vaginal mas baja (58.2% vs. 77.8%, p < 0.0005). La inducción del parto (OR = 2,9) y el peso del recién nacido (OR = 1.0001) se asociaron a un mayor riesgo de cesárea. Conclusión: La probabilidad de parto vaginal en estas pacientes disminuye cuanto mayor sea el peso del recién nacido y con partos inducidos. Sociedad Chilena de Obstetricia y Ginecologia https://hdl.handle.net/11441/177981 https://doi.org/10.24875/RECHOG.22000080 |
| spellingShingle | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success García Jiménez, Rocío Vaginal births after cesarean Repeat cesarean section Maternal mortality Neonatal mortality Obstetric delivery Parto vaginal tras cesárea Cesárea anterior Mortalidad materna Mortalidad neonatal Parto obstétrico |
| status_str | publishedVersion |
| title | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| title_full | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| title_fullStr | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| title_full_unstemmed | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| title_short | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| title_sort | Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success |
| topic | Vaginal births after cesarean Repeat cesarean section Maternal mortality Neonatal mortality Obstetric delivery Parto vaginal tras cesárea Cesárea anterior Mortalidad materna Mortalidad neonatal Parto obstétrico |
| topic_facet | Vaginal births after cesarean Repeat cesarean section Maternal mortality Neonatal mortality Obstetric delivery Parto vaginal tras cesárea Cesárea anterior Mortalidad materna Mortalidad neonatal Parto obstétrico |
| url | https://hdl.handle.net/11441/177981 https://doi.org/10.24875/RECHOG.22000080 |