Mode of delivery in women with antepartum fetal death and prior cesarean delivery

Am J Perinatol. 2010 Nov;27(10):825-30. doi: 10.1055/s-0030-1254548. Epub 2010 May 19.

Abstract

We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD ≥20 weeks' gestation or 500 g were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age ± standard deviation at delivery was 31.3 ± 6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • Fetal Death
  • Gestational Age
  • Gravidity*
  • Humans
  • Labor, Induced / adverse effects
  • Labor, Obstetric
  • Obstetric Labor Complications / etiology
  • Pregnancy
  • Stillbirth
  • Treatment Outcome
  • Trial of Labor
  • Vaginal Birth after Cesarean / adverse effects*
  • Young Adult

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