Trial of labor after cesarean section in risk pregnancies: a population ‐based cohort study

The objective of the study was to explore trial of labor and its failure in pregnancies with medical risk conditions, in a population with a high trial of labor rate.Material and methodsIn a cohort study (n=57  109), using data from the Medical Birth Registry of Norway 1989‐2014, women with a second delivery after a first pregnancy cesarean section were included. Preterm, multiple, and non‐cephalic deliveries were excluded. The outcomes were trial of labor and failed trial of labor, assessed as rates and relative risk, using deliveries without risk conditions as reference. Temporal trends were assessed by three‐year periods. The exposures were selected medical risk conditions, ie previous offspring death, labor dystocia, diabetes, heart conditions, chronic hypertension, chronic kidney disease , rheumatoid arthritis, thyroid disease, asthma, pre‐pregnancy psychiatric conditions, epilepsy, obesity, gestational diabetes, eclampsia and pre‐eclampsia, gestational hypertension, major malformations, second pregnancy psychiatric conditions, assisted reproduction, macrosomia, and small for ge station age neonates. Induced onset of labor was compared to spontaneous onset of labor for each condition studied.ResultsIn risk pregnancies (n=31  994) the trial of labor rate was 64.9% and failure rate was 27.6%, compared to 74.6% and 16.4% in pregnancies without any of the risk conditions studied. (n=25 115). The lowest trial of labor rates were observed in diabetes t...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research

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