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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This publication is provided for historical reference only and the information may be out of date.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 R-1Infection rates for trial of labor versus elective repeat cesarean delivery
| Author, year | Study description | N | Fever | Fever per 10,000 | Endometritis Chorio-amnionitis | Endometritis or Chorio-amnionitis per 10,000 | Wound/Other | Wound/Other per 10,000 |
|---|---|---|---|---|---|---|---|---|
| Term gestational age | ||||||||
| Eriksen, 19891 | Retrospective cohort military base | 139 | TOL: 4/71 (5.6%) ERCD: 7/68 (10.2%) (p:NS) | TOL: 560 ERCD: 1020 (p:NS) | TOL: 2/71 (2.8%) ERCD: 1/68 (1.5%) (p:NS) | TOL: 280 ERCD: 150 | Not reported | |
| Hook, 19972 | Prospective cohort level 1, 2, & 3 hospital included | 989 | Maternal fever TOL: 38/492 (8%) ERCD: 0/497 (0%) (p=<0.0002) | Maternal fever TOL: 80 ERCD: 0 (p=<0.0002) | Not reported | Not reported | Not reported | Not reported |
| Loebel,20043 | Retrospective cohort community teaching hospital | 1,408 | Not reported | Not reported | Not reported | Not reported | “Infection” ERCD: 11/481 (1.9%) VBAC 14/749 (2.3%) TOL-CD 9/178 (5.1%) (p:NS) | Infection” ERCD: 190 VBAC 230 TOL-CD 510 (p:NS) |
| Spong, 20074 | MFMU network cohort 19 university hospitals | 39,117 | Not reported | Not reported | TOL: 442/15,323 (2.9%) ERCD no labor: 260/14,993(1.7 %) ERCD + labor: 101/2721 (3.7%) IRCD no labor 137/5002 (2.7%) IRCD + labor: 54/1078 (5.0%) | TOL: 290 ERCD no labor: 170 ERCD + labor: 370 IRCD no labor 270 IRCD + labor: 500 | Not reported | Not reported |
| Wen, 20045 | Retrospective cohort Canadian registry ICD-9 codes | 308,755 | Not reported | Not reported | Not reported | Not reported | “Postpartum Infection” TOL: 487/128,960 (0.38%) ERCD: 837/179,795 (0.47%); Adjusted odds ratio: 0.86 (0.77–0.97) | “Postpartum Infection” TOL: 380 ERCD: 470 Adjusted odds ratio: 0.86 (0.77–0.97) |
| All gestational ages | ||||||||
| Bais, 20016 | Prospective cohort Netherlands regional hospital | 252 | TOL: 16/184 (9%) ERCD: 7/68 (10%) | TOL: 900 ERCD: 1000 | Not reported | Not reported | Not reported | Not reported |
| Cahill, 20067 | Retrospective cohort 16 university & community hospitals | 6,619 | TOL: 329/5041 (6.52%) ERCD: 294/1578(18.63 %) | TOL: 652 ERCD: 1863 | Not reported | Not reported | Not reported | Not reported |
| Durnwald, 20048 | Retrospective cohort university hospital | 768 | TOL: 27/522(5.2%) VBAC: 7/344(2.0%) TOL-CD: 20/178 (11.2%) ERCD: 6/246 (2.4%) | TOL: 520 VBAC: 200 TOL-CD: 1120 ERCD: 240 | Chorio- amnionitis TOL: 31/522(5.9%) VBAC: 18/344(5.2%) TOL-CD: 13/178(7.3%) ERCD: 0/246(0%) Endometritis TOL: 24/522 (4.6%) VBAC: 7/344(2%) TOL-CD: 17/178(9.6%) ERCD: 5/246(2%) | Chorio- amnionitis TOL: 590 VBAC: 520 TOL-CD: 730 ERCD: 0 Endometritis TOL: 460 VBAC: 200 TOL-CD: 960 ERCD: 200 | Not reported | Not reported |
| Flamm, 19949 | Prospective cohort 10 Kaiser hospital in California | 7,229 | TOL: 638/5022 (12.7%) ERCD: 362/2208 (16.4%) | TOL: 1270 ERCD: 1640 | Not reported | Not reported | Not reported | Not reported |
| McMahon, 199610 | Retrospective cohort population based longitudinal study Canada | 6,138 | TOL: 171/3424 (5.3%) ERCD: 185/2889 (6.4%) | TOL: 530 ERCD: 640 | Not reported | Not reported | Wound TOL 43/3424 (1.3%) ERCD 63/2889 (2.2%) | Wound TOL 130 ERCD 220 |
| Phelan, 198711 | Prospective Cohort University hospital ≥ 2 prior CD only | 2,643 | Planned TOL 159/1,796 (8.9%)* VBAC: 53/1465 (3.6%) TOL-CD: 106/331 (32%) No Planned TOL 163/847 (19.2%) VBAC: 4/69 (5.8%) ERCD: 56/314 (18%) IRCD: 103/464 (22%) | Planned TOL 890* VBAC: 360 TOL-CD: 320 No Planned TOL 1920 VBAC: 580 ERCD: 1800 IRCD: 2200 | Not reported | Not reported | Not reported | Not reported |
| Kugler, 200812 | Retrospective cohort Israel University grand multiparous | 1,102 | IRCD† 10/328 (3%), TOL: 9/619(1.5%), VBAC: 1/155(0.6%) | IRCD† 300 TOL: 150 VBAC: 60 | Amnionitis IRCDa 4/328(1.2%) TOL: 5/619 (0.8%), VBAC: 14/155 (9.0%) | Amnionitis IRCDa 120 TOL: 80 VBAC: 900 | Not reported | Not reported |
| Eglinton, 198413 | Retrospective cohort university hospital | 871 | VBAC: 6/240(2.5%) TOL-CD: 27/136 (19.8%) ERCD: 176/495 (35.5%) | VBAC: 250 TOL-CD: 1980 ERCD: 3550 | Not reported | Not reported | Not reported | Not reported |
| Chauhan, 200114 | 69 | Not reported | Not reported | TOL: 9/30 (30%) ERCD: 7/39 (18%) | TOL: 300 ERCD: 1800 | Wound TOL: 8/30(27%) ERCD: 3/39(8%) | Wound TOL: 2700 ERCD: 800 | |
| Hibbard, 200115 | Prospective cohort university hospital | 2,450 | Not reported | Not reported | Endometritis ERCD: 38/431 (8.8%) TOL: 108/1,324 (8.2%) VBAC: 31/908 (3.4%) TOL-CD: 77/416 (18.5%) Chorio- amnionitis ERCD: 18/431 (4.2%) TOL: 169/1,324 (12.8%) VBAC: 102/908 (11.2%) TOL-CD: 67/416 (16%) | Endometritis ERCD: 880 TOL: 820 VBAC: 340 TOL-CD: 1850 Chorio- amnionitis ERCD: 420 TOL: 1280 VBAC: 1120 TOL-CD: 1600 | Not reported | Not reported |
| Martin, 198316 | Prospective cohort 2 university centers | 709 | Not reported | Not reported | Endometritis VBAC: 1/101(1%) TOL-CD: 7/61 (11.5%) ERCD: 42/547 (7.7%) TOL: 8/162 = 4.9% | Endometritis VBAC: 100 TOL-CD: 1150 ERCD: 770 TOL: 490 | Wound VBAC: 0/101 TOL-CD: 3/61 (4.9%) ERCD: 12/547 (2.2%) Any TOL: 3/162 (1.9%) Pulmonary: VBAC: 5/101 (5%) TOL-CD: 1/61 (1.6%) ERCD: 31/547 (5.7%) Other: VBAC: 3/101 (3%) TOL-CD: 2/61 (3.2%) ERCD:36/547(6.6%) | Wound VBAC: 0 TOL-CD: 490 ERCD: 220 Any TOL: 190 Pulmonary VBAC: 500 TOL-CD: 160 ERCD: 570 Other: VBAC: 300 TOL-CD: 320 ERCD: 660 |
- *
p < .05;
- †
includes both ERCD as well as emergency CD
Abbreviations: ERCD=elective repeat cesarean delivery; IRCD=indicated repeat cesarean delivery; NS=not significant; TOL=trial of labor; TOL-CD=trial of labor followed by a cesarean delivery; UTI=urinary tract infection; VBAC=vaginal birth after cesarean
References
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- Detailed Infection Table - Vaginal Birth After Cesarean: New InsightsDetailed Infection Table - Vaginal Birth After Cesarean: New Insights
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