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...

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Autores: García Jiménez, Rocío, Valero, Irene, Weber Fernández, Ana María, Florez, Natalia, Martínez Aguado, Irene, Borrero González, Carlota
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/177981
Acceso en línea:https://hdl.handle.net/11441/177981
https://doi.org/10.24875/RECHOG.22000080
Access Level:acceso abierto
Palabra clave: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
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spelling Attempted vaginal birth after cesarean: assessment of morbidity and predictors of successParto tras cesárea anterior: análisis de la morbimortalidad materno-fetalGarcía Jiménez, RocíoValero, IreneWeber Fernández, Ana MaríaFlorez, NataliaMartínez Aguado, IreneBorrero González, CarlotaVaginal births after cesareanRepeat cesarean sectionMaternal mortalityNeonatal mortalityObstetric deliveryParto vaginal tras cesáreaCesárea anteriorMortalidad maternaMortalidad neonatalParto obstétricoObjective: 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 GinecologiaCirugía2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/177981https://doi.org/10.24875/RECHOG.22000080reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésRevista Chilena de Obstetricia y Ginecologia, 87 (6), 388-395.https://www.rechog.com/frame_esp.php?id=125info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1779812026-06-17T12:51:07Z
dc.title.none.fl_str_mv Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success
Parto tras cesárea anterior: análisis de la morbimortalidad materno-fetal
title Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success
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
title_short 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_sort Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success
dc.creator.none.fl_str_mv García Jiménez, Rocío
Valero, Irene
Weber Fernández, Ana María
Florez, Natalia
Martínez Aguado, Irene
Borrero González, Carlota
author García Jiménez, Rocío
author_facet García Jiménez, Rocío
Valero, Irene
Weber Fernández, Ana María
Florez, Natalia
Martínez Aguado, Irene
Borrero González, Carlota
author_role author
author2 Valero, Irene
Weber Fernández, Ana María
Florez, Natalia
Martínez Aguado, Irene
Borrero González, Carlota
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Cirugía
dc.subject.none.fl_str_mv 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 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
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.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/177981
https://doi.org/10.24875/RECHOG.22000080
url https://hdl.handle.net/11441/177981
https://doi.org/10.24875/RECHOG.22000080
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Revista Chilena de Obstetricia y Ginecologia, 87 (6), 388-395.
https://www.rechog.com/frame_esp.php?id=125
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Sociedad Chilena de Obstetricia y Ginecologia
publisher.none.fl_str_mv Sociedad Chilena de Obstetricia y Ginecologia
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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