Influence of the second stage of labor on maternal and neonatal outcomes in vaginal births after caesarean section: a multicenter study in Germany
| Autor: | Sascha Baum, Ibrahim Alkatout, M Kocaer, Antonio Simone Laganà, Achim Rody, Leila Allahqoli, Alexandros Sotiriadis, Konstantinos Dinas, L Proppe, S Sommer, A K Ertan, Georgios Gitas |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Reproductive medicine Subgroup analysis Maternal outcome 03 medical and health sciences 0302 clinical medicine Labor Stage Second Pregnancy medicine.artery Medicine Intubation Humans TOLAC Caesarean section 030212 general & internal medicine Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Vaginal delivery Obstetrics Incidence (epidemiology) Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Umbilical artery Retrospective cohort study Gynecology and obstetrics Neonatal outcome Vaginal Birth after Cesarean VBAC Prolonged second stage Trial of Labor RG1-991 Female business Research Article |
| Zdroj: | BMC Pregnancy and Childbirth BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-8 (2021) |
| ISSN: | 1471-2393 |
| Popis: | Background The American College of Obstetricians and Gynecologists (ACOG) introduced a new standard of care in 2014, extending the duration of the second stage of labor in order to reduce caesarean delivery (CD) rates and its severe complications. The aim of the present study is to evaluate success rates of trial of labor after caesarean section (TOLAC), as well as maternal and neonatal outcomes after the establishment of the recent guidelines. Methods A retrospective study was performed at two large departments in Germany from January 2008 to January 2018. Patients undergoing TOLAC were divided into two groups. Group I (958 patients) was constituted before the establishment of the current guidelines, and Group II (588 patients) after the establishment of the guidelines. A subgroup analysis was performed to compare neonatal outcomes after successful TOLAC and operative vaginal delivery with those after failed TOLAC and secondary CD. Results The success rate of vaginal births after cesarean section (VBAC) fell from 66.4% in Group I to 55.8% in Group II (p p = 0.108), the 5-min Apgar scores below 7 (p = 0.224) and intubation (p = 0.547). However, the transfer rates to the neonatal care unit were significantly higher in Group II than in Group I (p Conclusion Extending the second stage of labor does not necessarily result in more vaginal births after TOLAC. Maternal and neonatal outcomes were similar in both groups. Further studies will be needed to evaluate the role of operative vaginal delivery and the duration of the second stage of labor in TOLAC. |
| Databáze: | OpenAIRE |
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