TY - JOUR
T1 - Safety of vaginal birth after cesarean
T2 - A systematic review
AU - Guise, Jeanne Marie
AU - Berlin, Michelle
AU - McDonagh, Marian
AU - Osterweil, Patricia
AU - Chan, Benjamin
AU - Helfand, Mark
PY - 2004/3
Y1 - 2004/3
N2 - OBJECTIVE: To evaluate the benefits and harms of vaginal birth after cesarean compared with repeat cesarean delivery. DATA SOURCES: The computerized databases MEDLINE, EMBASE, HealthSTAR, Cochrane CENTRAL, and National Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effectiveness, along with reference lists and national experts, were used to conduct this review. METHODS OF STUDY SELECTION: All studies that reported data for maternal or infant outcomes in women with prior cesarean delivery were eligible. Methodological quality was evaluated for each study with the criteria of the United States Preventive Services Task Force and the National Health Service Centre for Reviews and Dissemination. Twenty of 6,828 potentially relevant articles (55,506 patients) were included in the analysis. TABULATION, INTEGRATION, AND RESULTS: Two authors independently abstracted information on study design, sample size, participant characteristics, and maternal and fetal health outcomes by using a standardized protocol. Rates of vaginal delivery in women undergoing a trial of labor ranged from 60% to 82%. There was no significant difference in maternal deaths or hysterectomy between trial of labor and repeat cesarean. Uterine rupture was more common in the trial-of-labor group, but rates of asymptomatic uterine dehiscence did not differ. Studies conflicted on the effect of induction of labor on these outcomes. Data regarding infant outcomes were poor. CONCLUSION: Safety in childbirth for women with prior cesarean is a major public health concern. Methodological deficiencies in the literates evaluating the relative safety of vaginal birth after cesarean compared with repeat cesarean delivery are striking. The identification of high-risk and low-risk groups of women and settings for morbidity remains a key research priority.
AB - OBJECTIVE: To evaluate the benefits and harms of vaginal birth after cesarean compared with repeat cesarean delivery. DATA SOURCES: The computerized databases MEDLINE, EMBASE, HealthSTAR, Cochrane CENTRAL, and National Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effectiveness, along with reference lists and national experts, were used to conduct this review. METHODS OF STUDY SELECTION: All studies that reported data for maternal or infant outcomes in women with prior cesarean delivery were eligible. Methodological quality was evaluated for each study with the criteria of the United States Preventive Services Task Force and the National Health Service Centre for Reviews and Dissemination. Twenty of 6,828 potentially relevant articles (55,506 patients) were included in the analysis. TABULATION, INTEGRATION, AND RESULTS: Two authors independently abstracted information on study design, sample size, participant characteristics, and maternal and fetal health outcomes by using a standardized protocol. Rates of vaginal delivery in women undergoing a trial of labor ranged from 60% to 82%. There was no significant difference in maternal deaths or hysterectomy between trial of labor and repeat cesarean. Uterine rupture was more common in the trial-of-labor group, but rates of asymptomatic uterine dehiscence did not differ. Studies conflicted on the effect of induction of labor on these outcomes. Data regarding infant outcomes were poor. CONCLUSION: Safety in childbirth for women with prior cesarean is a major public health concern. Methodological deficiencies in the literates evaluating the relative safety of vaginal birth after cesarean compared with repeat cesarean delivery are striking. The identification of high-risk and low-risk groups of women and settings for morbidity remains a key research priority.
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U2 - 10.1097/01.AOG.0000116259.41678.f1
DO - 10.1097/01.AOG.0000116259.41678.f1
M3 - Review article
C2 - 14990401
AN - SCOPUS:85047692196
SN - 0029-7844
VL - 103
SP - 420
EP - 429
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 3
ER -