Study: Vaginal birth after 2nd & 3rd c/s

The outcome and cumulative morbidity associated with the second and third postcesarean delivery - American Journal of Perinatology , vol 24, no 8, 2007, pp 483-486 Gonen R; Barak S; Nissenblat V; et al - (2007)

The purpose of this study was to compare the outcome and cumulative morbidity among women who delivered twice after a cesarean delivery (CD), and who underwent in the second delivery either a trial of labor (TOL) or planned cesarean delivery (PCD). Eligible women (N = 399) were divided into two groups based on first post-CD: a TOL (n = 304) or PCD (n = 95).

Women attempting a TOL were successful in 70 and 75% in the first and second post-CD, respectively.

All participants undergoing a PCD subsequently had a third PCD. The overall morbidity was 8.4 and 5.3% among PCD and TOL groups, respectively (p = 0.258).

Women attempting a TOL after a previous CD had a 70 and 53% likelihood for at least one successful or two successful vaginal births in the two subsequent deliveries, respectively. No significant difference was documented between the groups regarding the cumulative morbidity. (11
references) (Author)