Cesarean Delivery Affecting Fetus or Newborn, Hemorrhagic Complications, Labor (Obstetrics)--Complications
Conditions
Keywords
previous CS, trial of labor, maternal outcomes, fetal outcomes, neonatal outcomes
Brief summary
In 2015 ObGyn Dept of Santo Spirito Hospital in Pescara (Italy) started protocol for previous CS vaginal birth. In 2021 was started a protocol for training on obstetric emergencies and protocol on two previous cesarean was endorsed. Patients attending birth in Pescara with two previous from january 2016 to December 2020, and from january 2021 to december 2025 were collected. A different counseling approach was adopted from 2021. Women's acceptance of trial of labor and maternal and fetal outcomes were collected.
Detailed description
Women attending birth in Santo Spirito Hospital with 2 previous CS were collected. Exclusion Criteria: * Patients with clinical indication to CS * a previous CS less than 18 month before * breech presentations * triplets * premature labor before 34 completed weeks' gestation The first period was starting January 1st 2016 to December 31st 2020. The second period was starting January 1st 2021 to December 31st 2025 Primary outcomes: * incidence of trial of labor acceptance * incidence of vaginal birth Secondary outcomes: * maternal adverse outcomes (PPH, blood transfusion, vaginal tears, hysterectomy, maternal death) * fetal adverse outcomes (fetal death, NICU stay, APGAR score less than 7 at 5')
Interventions
PROCEDUREAcceptance, rate of vaginal birth and safety
In 2021 started a new delivery protocol enhancing the opportunity of having a trial of labor in women with a history of two previous CS. Rate of acceptance, rate of successful vaginal birth, maternal and fetal outcomes were evaluated
Sponsors
G. d'Annunzio University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* pregnant women * pregnancy above 34 weeks' gestation * cephalic presentation of the fetus * singleton and twins * diamniotic twins * 2 previous CS * more than 18 months from last CS * no other indication to CS
Exclusion criteria
* pregnancy below 34 weeks' gestation * breech baby * triplets or high order multiple pregnancies * more than 2 previous CS * less than 18 months from last CS * precence of other indications to CS (i.e. maternal diseases, placenta previa, etc.)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| vaginal birth after 2 cesarean | 5 years | Incidence of patients having a vaginal birth after 2 CS |
| accepted indication to trial of labor | 5 years | incidence of women accepting indication to trial of labor |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| emergency CS | 5 years | incidence of emergency CS |
| maternal outcomes | 5 years | incidence of adverse maternal outcomes (PPH, blood transfusion, vaginal tears, hysterectomy) |
| Fetal and Neonatal adverse outcomes | 5 years | Incidence of fetal/neonatal death, NICU stay, APGAR score below 7 at 5' |
Countries
Italy
Contacts
Primary ContactClaudio Celentano, MD
Outcome results
None listed