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Trial of labor vs elective C-section: Which is better for women with two prior C-sections?

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Created On: 02/09/2023

Trial of labor versus elective cesarean delivery

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In women who have undergone two previous C-sections, a trial of labor seems to be a reasonable choice when compared to an elective C-section.

In a retrospective observational comparative study, researchers have found compelling evidence to support the safety and success of vaginal birth after two cesarean sections (C-sections). Researchers aimed to assess and compare maternal and neonatal outcomes based on the planned method of delivery among females who underwent cesarean sections twice.

This study utilized propensity score analysis to examine neonatal outcomes (fatality, transfer to neonatal unit, Apgar scores, cord lactates, and cord pH) based on the planned mode of delivery. Additionally, maternal outcomes such as mortality, post-partum hemorrhage, and uterine rupture were considered as secondary endpoints.

Out of the 410 eligible subjects with two previous cesarean sections, 358 cases (87.3%) underwent prophylactic cesarean delivery, while the remaining 52 volunteers (12.7%) opted for a trial of labor, with a success rate of 67.3%. The neonatal weight, APGAR scores at 1, 5, and 10 minutes, as well as cord blood pH, were similar in both groups.

However, one instance of uterine rupture was observed in the trial of labor arm. In a specific population, attempting a trial of labor appears to be a suitable mode of delivery for women who have undergone two prior cesarean sections.