Trial of labor after cesarean delivery: The effect of previous vaginal delivery

A. B. Caughey, T. D. Shipp, John Repke, C. Zelop, A. Cohen, E. Lieherman

Research output: Contribution to journalArticle

62 Scopus citations

Abstract

OBJECTIVE: This study examined the effects of order of previous modes of delivery on the rate of cesarean delivery and duration of a trial of labor among women with a history of 1 previous cesarean delivery and 1 previous vaginal delivery. STUDY DESIGN: The medical records of 4393 women at our institution who were seen June 1984-July 1996 for a trial of labor after a previous cesarean delivery were abstracted. The 800 women with a history of 1 previous cesarean and 1 previous vaginal delivery were included in this analysis. They were split into 2 groups by obstetric history: (1) 1 cesarean delivery followed by 1 vaginal delivery (vaginal last) and (2) 1 vaginal delivery followed by 1 cesarean delivery (cesarean last). Patient characteristics, durations of labor, and rates of cesarean delivery were compared with ξ2 analysis, the student t test, and the Wilcoxon rank sum test. Possible confounding variables were controlled for with multivariate logistic regression. RESULTS: The rates of cesarean delivery for the vaginal last and cesarean last groups were 7.2% and 14.7%, respectively (P= .002). The median durations of labor for the vaginal last and cesarean last groups were 5.6 and 7.0 hours, respectively (P = .01). The differences in cesarean rates and durations of labor were seen regardless of the indication for the previous cesarean delivery. CONCLUSIONS: Among women with 1 previous cesarean and 1 previous vaginal delivery, those whose most recent delivery was vaginal had a lower rate of cesarean delivery and shorter duration of labor than did those whose most recent delivery was cesarean.

Original languageEnglish (US)
Pages (from-to)938-941
Number of pages4
JournalAmerican Journal of Obstetrics and Gynecology
Volume179
Issue number4
DOIs
StatePublished - Jan 1 1998

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

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