Affiliations: [a]
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| [b]
Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
Correspondence:
[*]
Address for correspondence: Jaclyn M. Phillips, MD. Division of Maternal Fetal Medicine, George Washington University Medical Faculty Associates, 2150 Pennsylvania Ave, Washington, DC 20037, USA. Tel.: +1 202 741 2521; Fax: +1 202 741 2550; E-mail: japhillips@mfa.gwu.edu.
Abstract: BACKGROUND:
The aim of our study is to describe maternal and neonatal morbidity and mortality in patients undergoing trial of labor after cesarean from the Consortium on Safe Labor. METHODS:
This was a secondary analysis of the Consortium on Safe Labor database, a retrospective cohort study over a 7 year study period. Maternal and neonatal outcomes were evaluated based on desired delivery mode: planned elective repeat cesarean delivery or trial of labor after cesarean. RESULTS:
Of 9858 patients in our analysis, our study population had 4400 patients (45%) who desired trial of labor after cesarean and 5458 patients (55%) who desired elective repeat cesarean delivery. Women who attempted trial of labor after cesarean compared to those who had an elective repeat cesarean delivery were more likely to have an obstetric hemorrhage (adjusted odds ratio 1.6; 95% CI 1.3 –2.0) and blood transfusion (adjusted odds ratio 2.3; 95% CI 1.6 –3.2). CONCLUSION:
Maternal morbidity in women undergoing trial of labor after cesarean was predominantly hemorrhage-related.
Keywords: Cesarean delivery, maternal morbidity, obstetric hemorrhage, perinatal counseling, trial of labor after cesarean
