NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Guise JM, Eden K, Emeis C, et al. Vaginal Birth After Cesarean: New Insights. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Mar. (Evidence Reports/Technology Assessments, No. 191.)
This publication is provided for historical reference only and the information may be out of date.
Table Q-1Transfusion rates for trial of labor versus elective repeat cesarean delivery among any gestational age studies
| Author, year | Study description | N | Blood transfusion | Blood Transfusion per 10,000 | Hemorrhage | Hemorrhage Rate per 10,000 |
|---|---|---|---|---|---|---|
| Term gestational age | ||||||
| Gregory, 20081 | Retrospective cohort Low-risk = absence of maternal complications High-risk = any maternal condition ICD-9 codes | 41,450 | Low-risk TOL: 38/8292 (0.46%) ERCD: 69/20,834 (0.33%) High-risk TOL: 25/3188 (0.78%) ERCD: 84/9136 (0.92%) | Low-risk TOL: 46 ERCD: 33 High-risk TOL: 78 ERCD: 92 | Low-risk TOL: 196/8292 (2.36%) ERCD: 142/2083 (6.82%) High-risk TOL: 104/3188 (3.26%) ERCD: 144/9136 (1.57%) | Low-risk TOL:236 ERCD: 682 High-risk TOL:326 ERCD: 157 |
| Loebel, 20042 | Retrospective Cohort, Community Teaching Hospital | 1,408 TOL: 927 ERCD: 481 | TOL: 12/927 (1.29%) ERCD: 3/481 (0.62%) | TOL: 129 ERCD: 62 | Not reported | Not reported |
| Spong 20073 | MFMU study19 Academic centers | 39,117 | TOL: 227/15,323 (1.48%) ERCD: no labor: 138/14,993 (0.92%) ERCD + labor: 45/2721 (1.65%) IRCD no labor: 107/5002 (2.14%) IRCD + labor: 23/1078 (2.13%) | TOL: 148 ERCD: no labor: 92 ERCD + labor: 165 IRCD no labor: 214 IRCD + labor: 213 | Not reported | Not reported |
| Wen, 20044 | Retrospective cohort Canadian Registry ICD-9 codes | 308,755 | TOL: 245/128,960 (0.19%) ERCD: 268/179,795 (0.15%), adjusted odds ratio 1.67 (1.39–2.00) | TOL: 19 ERCD: 15 adjusted odds ratio 1.67 (1.39–2.00) | Not reported | Not reported |
| Any gestational age | ||||||
| Bais, 20015 | Prospective Cohort Netherlands Regional hospital | 252 | TOL: 8/184 (4.35%) ERCD: 4/68 (5.88%) | TOL: 435 ERCD: 588 | Hemorrhage >500 mL TOL: 31/184 (16.85%) ERCD: 20/68 (29.41%) Hemorrhage >1000 mL TOL: 9/184 (4.89%) ERCD: 6/68 (8.83%) | Hemorrhage >500 mL TOL: 168.5 ERCD: 294.1 Hemorrhage >1000 mL TOL: 489 ERCD: 8.83% |
| Flamm, 19946 | Prospective cohort 10 Kaiser Hospital in CA | 7229 | VBAC: 25/3516 (0.71%) ERCD: 38/2208 (1.72%) (p=.0001) | VBAC: 71 ERCD: 172 (p=.0001) | Not reported | Not reported |
| Hibbard, 20017 | Prospective Cohort University Hospital | 2450 | ERCD: 6/431 (1.40%) TOL: 11/1,324 (0.83%) VBAC: 4/908 (0.44%) TOL-CD: 7/416 (1.68%) | ERCD: 140 TOL: 83 VBAC: 44 TOL-CD: 168 | >1,000mL ERCD: 32/431 (7.42%) TOL: 46/1,324 (3.47%) VBAC: 7/908 (0.77%) TOL-CD: 39/416 (9.37%) >2,000mL ERCD: 5/431 (1.16%) TOL: 8/1,324 (0.60%) VBAC: 3/908 (0.33%) TOL-CD: 5/416 (1.20%) | >1,000mL ERCD: 742 TOL:347 VBAC: 77 TOL-CD: 937 >2,000mL ERCD: 116 TOL: 60 VBAC: 33 TOL-CD: 120 |
| Kugler, 20088 | Retrospective cohort Israel University Grand Multiparous women | 1102 | ERCD: 18/328 (5.49%) TOL: 8/155 (5.16%) VBAC: 6/619 (1.0%) p<0.001 | ERCD: 549 TOL: 516 VBAC: 100 p<0.001 | ERCD: 3/328 (0.91%), TOL: 1/155 (0.64%), VBAC: 5/619 (0.81%) p <0.001 | ERCD: 91 TOL: 64 VBAC: 81 p <0.001 |
| Martin, 19839 | Prospective Cohort 2 University Centers | 709 | Not reported | Not reported | VBAC: 6/101 (5.94%) TOL-CD: 9/61 (14.75%) ERCD: 57/547 (10.42%) | VBAC: 594 TOL-CD: 1475 ERCD: 1042 |
| McMahon, 199610 | Retrospective cohort Population based Longitudinal study Canada | 6,138 | TOL: 36/3429 (1.05%) ERCD: 39/2889 (1.35%) | TOL: 105 ERCD: 135 | Not reported | |
| Obara, 199711 | Prospective Cohort University Hospital, Japan | 310 | Not reported | Not reported | ERCD: 4/96 (4.17%) TOL: 3/214 (1.40%) | ERCD: 417 TOL: 140 |
Abbreviations: CA=California; ERCD=elective repeat cesarean delivery; IRCD=indicated repeat cesarean delivery; MFMU=Maternal-Fetal Medicine Units Network; mL=milliliter; TOL=trial of labor; TOL-CD=trial of labor followed by a cesarean delivery; VBAC=vaginal birth after cesarean
References
- 1.
- Gregory KD, Korst LM, Fridman M, et al. Vaginal birth after cesarean: clinical risk factors associated with adverse outcome. Am J Obstet Gynecol. 2008;198(4):452.e451–410. discussion 452.e410–452. [PubMed: 18395037]
- 2.
- Loebel G, Zelop CM, Egan JFX, Wax J. Maternal and neonatal morbidity after elective repeat Cesarean delivery versus a trial of labor after previous Cesarean delivery in a community teaching hospital. J Matern Fetal Neonatal Med. 2004;15(4):243–246. [PubMed: 15280132]
- 3.
- Spong CY, Landon MB, Gilbert S, et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol. 2007;110(4):801–807. [PubMed: 17906012]
- 4.
- Wen SW, Rusen ID, Walker M, et al. Comparison of maternal mortality and morbidity between trial of labor and elective cesarean section among women with previous cesarean delivery. Am J Obstet Gynecol. 2004;191(4):1263–1269. [PubMed: 15507951]
- 5.
- Bais JM, van der Borden DM, Pel M, et al. Vaginal birth after caesarean section in a population with a low overall caesarean section rate. Eur J Obstet Gynecol Reprod Biol. 2001;96(2):158–162. [PubMed: 11384799]
- 6.
- Flamm BL, Goings JR, Liu Y, Wolde-Tsadik G. Elective repeat cesarean delivery versus trial of labor: a prospective multicenter study. Obstet Gynecol. 1994;83(6):927–932. [PubMed: 8190433]
- 7.
- Hibbard JU, Ismail MA, Wang Y, Te C, Karrison T. Failed vaginal birth after a cesarean section: how risky is it? I. Maternal morbidity. Am J Obstet Gynecol. 2001;184(7):1365–1371. discussion 1371–1363. [PubMed: 11408854]
- 8.
- Kugler E, Shoham-Vardi I, Burstien E, Mazor M, Hershkovitz R. The safety of a trial of labor after cesarean section in a grandmultiparous population. Arch Gynecol Obstet. 2008;277(4):339–344. [PubMed: 17957377]
- 9.
- Martin JN Jr, Harris BA Jr, Huddleston JF, et al. Vaginal delivery following previous cesarean birth. Am J Obstet Gynecol. 1983;146(3):255–263. [PubMed: 6859134]
- 10.
- McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF. Comparison of Q-4 a trial of labor with an elective second cesarean section.[see comment] N Engl J Med. 1996;335(10):689–695. [PubMed: 8703167]
- 11.
- Obara H, Minakami H, Koike T, Takamizawa S, Matsubara S, Sato I. Vaginal birth after cesarean delivery: results in 310 pregnancies. J Obstet Gynaecol Res. 1998;24(2):129–134. [PubMed: 9631601]
- Detailed Transfusion/Hemorrhage Table - Vaginal Birth After Cesarean: New Insigh...Detailed Transfusion/Hemorrhage Table - Vaginal Birth After Cesarean: New Insights
Your browsing activity is empty.
Activity recording is turned off.
See more...