Accessible Requires Authentication Published by De Gruyter September 4, 2012

Induction of labor after a prior cesarean delivery: lessons from a population-based study

Lea Shatz, Lena Novack, Moshe Mazor, Ruthy Beer Weisel, Doron Dukler, Tal Rafaeli-Yehudai, Osnat Israeli and Offer Erez

Abstract

Objectives: The aims of this study were (1) to determine the success rate of induction of labor (IOL) in women with a prior cesarean section (CS) and (2) to compare the perinatal outcome of a trial of labor (TOL) in women with one prior CS who had an IOL, spontaneous onset of labor, or an elective repeated CS (ERCS).

Material and methods: This study population was divided into three groups: women who had (1) ERCS (n=1916), (2) spontaneous TOL (n=4263), and (3) IOL (n=1576).

Results: (1) The rate of IOL in the study cohort was 20.3%; of these, 67.4% had a successful vaginal birth after cesarean (VBAC). (2) Patients in the spontaneous TOL group had a higher VBAC rate than did those who had IOL (P<0.001). (3) The rate of uterine rupture was comparable among all study groups. And (4) a prior vaginal birth increased the likelihood of having a successful induction and a VBAC by 50%.

Conclusion: IOL in patients with a previous CS is successful in about two-thirds of the cases. Induction is a safe and useful tool that can serve as an alternative for ERCS and assist to reduce the rate of ERCS.


Corresponding author: Offer Erez, MD, Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 151 Beer Sheva 84101, Israel, Tel.: +972-8-6400061, Fax: +972-8-6403294

Received: 2012-5-11
Revised: 2012-7-8
Accepted: 2012-7-30
Published Online: 2012-09-04
Published in Print: 2013-03-01

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