Objective: The purpose of this study was to assess the maternal morbidity associated with attempted vaginal birth after cesarean (VBAC) in twin gestations using a large, nationwide sample of deliveries.
Study Design: Data for this study were obtained from an administrative dataset, the Nationwide Inpatient Sample, a representative sample of discharges from non-Federal hospitals, for the years 1993 to 2002. Patients admitted nonemergently for the delivery of twin gestations who had a history of previous cesarean delivery were selected. Patients that either delivered vaginally or who had discharge codes that indicated labor before cesarean delivery were defined as the trial of labor group, while patients who had a cesarean delivery without discharge codes that indicated labor were defined as the elective cesarean group. Various complications of delivery were analyzed for each group.
Results: We identified 4705 women who underwent an elective cesarean delivery and 1850 women who underwent a trial of labor. For women who had a trial of labor, 836 (45.2%) delivered vaginally. The rate of uterine rupture was higher in the trial of labor group than in the elective cesarean group (0.9% vs 0.1%, P < .001), and the rate of wound complications was lower (0.6% vs 1.3%, P < .02). The rates of other complications including hysterectomy, transfusion, major postpartum infection, thromboembolism, uterine dehiscence, and pelvic hematoma were not significantly different between the 2 groups.
Conclusion: Our study showed a significantly higher rate of uterine rupture in the trial of labor group that is similar to the rates reported for trial of labor after cesarean in singleton pregnancies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ajog.2006.06.036 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Proposed Saffron Soilless Cultivation System for a Quality Spice as Certified by Genetic Traceability.
Plants (Basel)
December 2024
Department of Agricultural, Food and Environmental Sciences, University of Perugia, Borgo XX Giugno 74, 06121 Perugia, Italy.
Saffron ( L.) is one of the most expensive spices in the world due to its strong market demand combined with its labor-intensive production process, which needs a lot of labor and has significant costs. New cultivation methods and traceability systems are required to improve and valorize local Italian saffron production.
View Article and Find Full Text PDFLikelihood of Preterm Birth in Patients After Antenatal Corticosteroid Administration in Relation to Diagnosis and Confounding Risk Factors: A Retrospective Cohort Study.
Healthcare (Basel)
January 2025
Institute for Health Sciences, Department of Midwifery Science, University Hospital Tübingen, 72076 Tübingen, Germany.
: In the case of threatened preterm birth (PTB) before the 34th week of pregnancy, the application of antenatal corticosteroids (ACSs) for the maturation of the fetal lung is a standard procedure in perinatal medicine. Common diagnoses for ACS use in pregnancy are the preterm rupture of membranes (PPROMs), placental bleeding, premature labor, preeclampsia, oligohydramnios, amniotic infection syndrome (AIS), and cervical insufficiency. The aim of this study was to investigate whether the current diagnosis, which results in ACS, and the patient's risk factors influence the risk of PTB events.
View Article and Find Full Text PDFThe effects of dance on maternal childbirth: a systematic review and meta-analysis.
BMC Pregnancy Childbirth
January 2025
School of Nursing, Chongqing Medical University, Chongqing, 400016, China.
Background: Previous guidelines have clearly stated that dance is safe and beneficial during pregnancy and for childbirth. However, due to the small sample size of individual studies and different interventions, there were inconsistencies about the effect of dance on maternal childbirth.
Methods: We included studies evaluating the effect of dance on women in labor.
Effect of E-learning clinical management of substance-dependent pregnant women on the knowledge and clinical skill performance of midwives: a randomized controlled trial.
BMC Pregnancy Childbirth
January 2025
Maternal-Fetal Medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Drug use during pregnancy and post-partum undoubtedly significantly affects maternal and infant morbidity. Healthcare providers, especially midwives who care for pregnant and postpartum women, must possess adequate knowledge and clinical skills to manage their patients appropriately. This study aimed to determine the effect of an e-learning intervention on midwives' knowledge and clinical performance skills in caring for substance-dependent pregnant women during labor and post-partum.
View Article and Find Full Text PDFEffectiveness of psychodrama on mental health outcomes based on Chinese samples: A systematic review and meta-analysis of randomized controlled studies.
Glob Ment Health (Camb)
December 2024
Mental Health Education and Counseling Center, China University of Labor Relations, Beijing, China.
Background: Psychodrama (PD), supported by extensive global research, is increasingly becoming a vital method for alleviating psychological symptoms and promoting mental well-being in diverse populations across China. However, comprehensive evidence based on rigorous interventions is currently lacking.
Methods: This article systematically reviews the literature on randomized controlled experimental intervention studies of PD in the Chinese Mainland from 1982 to 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!