دورية أكاديمية
A Trial of Labor after Cesarean Section with a Macrosomic Neonate. Is It Safe?
| العنوان: | A Trial of Labor after Cesarean Section with a Macrosomic Neonate. Is It Safe? |
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| المؤلفون: | Lopian M; Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Kashani-Ligumski L; Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Cohen R; Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Herzlich J; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.; Department of Neonatology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Perlman S; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.; Prenatal Ultrasound Unit The Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel. |
| المصدر: | American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e400-e405. Date of Electronic Publication: 2022 Jun 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8405212 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8785 (Electronic) Linking ISSN: 07351631 NLM ISO Abbreviation: Am J Perinatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Thieme-Stratton, 1983- |
| مواضيع طبية MeSH: | Trial of Labor* , Vaginal Birth after Cesarean*/adverse effects , Vaginal Birth after Cesarean*/statistics & numerical data , Fetal Macrosomia* , Uterine Rupture*/etiology, Humans ; Female ; Retrospective Studies ; Pregnancy ; Adult ; Infant, Newborn ; Postpartum Hemorrhage/epidemiology ; Apgar Score ; Shoulder Dystocia/epidemiology ; Anal Canal/injuries ; Birth Weight |
| مستخلص: | Objective: This study aimed to determine whether a trial of labor after cesarean section (TOLAC) with a macrosomic neonate is associated with adverse outcomes. Study Design: A retrospective cohort study was conducted in a population motivated for TOLAC. Women attempting TOLAC with a neonatal birth weight >4,000 g were compared with women attempting TOLAC with neonatal birth weights between 3,500 and 4,000 g. The primary outcome was TOLAC success. Secondary outcomes included mode of delivery, uterine rupture, postpartum hemorrhage (PPH), shoulder dystocia, obstetric anal sphincter injury (OASI), Apgar's score <7 at 5 minutes, and umbilical artery pH <7.1. Data were analyzed using Fisher's exact test and Chi-square test. Results: Overall, 375 women who underwent TOLAC with a neonate weighing >4,000 g comprised the study group. One thousand seven hundred and eighty-three women attempting TOLAC with a neonate weighing 3,500 to 4,000 g comprised the control group. There were no clinically significant differences between the groups for maternal age, gestational age, parity, and vaginal birth after cesarean (VBAC) rate. There were no significant differences in the rates of successful TOLAC (94 vs. 92.3%, p = 0.2, odds ratio [OR] = 0.8, 95% confidence interval [CI]: 0.5, 1.2), operative vaginal delivery (7.4 vs. 5.3%, p = 0.18, OR = 0.7, 95% CI: 0.4, 1.1), uterine rupture (0.4 vs. 0%, p = 0.6), PPH (3.2 vs. 2.3%, p = 0.36, OR = 1.4, 95% CI: 0.7, 2.7), OASI (0.8 vs. 0.2%, p = 0.1, OR = 3.6, 95% CI: 0.8, 1.6), Apgar's score <7 at 5 minutes (0 vs. 0.4%, p = 0.37), and umbilical artery pH <7.1 (0.5 vs. 0.7%, p = 1.0, OR = 0.73, 95% CI: 0.2, 3.2). Women with a neonate weighing >4,000 g had a significantly increased risk of shoulder dystocia (4 vs. 0.4%, p < 0.05, OR = 9.2 95% CI: 3.9, 22) CONCLUSION: Women attempting TOLAC with a macrosomic neonate are not at increased risk for failed TOLAC, operative vaginal delivery, uterine rupture, PPH, or OASI but are at risk of shoulder dystocia. This information may aid in prenatal counseling for women considering TOLAC with a macrosomic fetus. Key Points: · TOLAC with fetal macrosomia does not increase the risk of uterine rupture.. · TOLAC with fetal macrosomia is associated with high chances of VBAC.. · TOLAC with fetal macrosomia is not associated with adverse neonatal outcomes.. Competing Interests: None declared. (Thieme. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20220624 Date Completed: 20240520 Latest Revision: 20240729 |
| رمز التحديث: | 20240730 |
| DOI: | 10.1055/a-1884-1221 |
| PMID: | 35750318 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8785 |
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| DOI: | 10.1055/a-1884-1221 |