Trial of Labor After Cesarean, Trial of Labor; Failure
Conditions
Keywords
trial of labor after cesarean, failure of labor, induction of labor after cesarean
Brief summary
in 2015 a protocol for trail of labor after a single cesarean delivery was approved by medical committee of Pescara Hospital. A database from outpatient clinic evaluated all women after 34 weeks' gestation with a previous cesarean delivery. Patients with a specific medical indication for cesarean delivery were skipped, whilst the others were recruited within repetitive elective cesarean delivery or trial of labor based on maternal request. Patients were couselled on the opportunity of having a mechanical induction/ rupture of membranes and subsequent oxytocin infusion if needed due to prolonged gestation (above 41 weeks plus 3 days) or medical indication to delivery (i.e. gestational diabetes, hypertension, SGA, etc.)
Detailed description
All pregnant women with a previous CD attending Labor Ward of Santo Spirito Hospital of Pescara Italy (affiliated to University of Chieti Pescara) were enrolled at outpatient clinic after internal protocol registration for trial of labor in previus cesarean delivery. Patinets with a medical indication to CD were not elegible. Sociodemographic data such as ethnic background, maternal age, gestational age at delivery, previous vaginal birth, indications to previous CD, and maternal willingness to RECD ot TOLAC were recorded. Maternal decision to switch to different intervention were recorded. Outcome of RECD and TOLAC were recorded.
Interventions
PROCEDURErepetitive elective CD
maternal and neonatal outcomes
Sponsors
G. d'Annunzio University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 57 Years
Healthy volunteers
No
Inclusion criteria
* pregnant women * previous CD
Exclusion criteria
* below 34 weeks' gestation * medical indication to CD
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| incidence of maternal request for trial of labor | 11 years | incidence of women with request of trial of labor through the time |
| incidence of VBAC | 11 years | number of vaginal birth through the time |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| maternal adverse outcome | 11 years | maternal adverse outcome such as PPH, emergency CS, surgical complications |
| neonatal adverse outcome | 11 years | NICU stay, low APGAR score (\<7 at 5'), fetal death |
Contacts
PRINCIPAL_INVESTIGATORClaudio Celentano, MD
University of Chieti Pescara School of Medicine
Outcome results
None listed