A large study of women who have had one or more caesarean section previews suggest that you try a vaginal birth in a subsequent pregnancy is associated with biggest risk of health both for the mother and the baby to opt for a surgery again.
The research, published in the open access journal "PLOS Medicine", addresses the lack of solid information on the results of the options for birth after a prior c-section and can be used to counsel women about their choices.
In all the world there has been an increase in the cesarean delivery, which leads to a higher proportion of pregnant women with a history of cesarean section. The guidelines recommend that these women will receive advice on the benefit and harm planning a c-section later, or try for a vbac, however, there is little evidence in this respect.
Kathryn Fitzpatrick, of the Department of Health of the Population of Nuffield, University of Oxford, and colleagues used data from 74.043 births to term infants in Scotland between 2002 and 2015. For women who had a prior cesarean, the researchers estimated the health outcomes of maternal and perinatal short-term associated with the attempt of a vaginal birth compared with planning another c-section.
A total of 45.579 women gave birth by caesarean section is planned and there were other 28.464 attempts vaginal delivery, 28.4% of which had an emergency c-section .
Try the vaginal birth associated with an increased risk that the mother has serious problems of birth and postpartum in comparison with the choice of another c-section. So, try the vaginal birth was more likely to cause uterine rupture , a blood transfusion, sepsis, surgical injury and results more serious in infants, such as fetal death, admission to neonatal unit, resuscitation which require medications or intubation, or Apgar score less than seven at five minutes.
The absolute risk of complications was small, for any type of delivery. In general, only 1.8% of those who attempted a vaginal birth and 0.8% of those who had a c-section planned experienced maternal complications serious. The 8% of those who attempted a vaginal delivery and 6.4% of those who have had a c-section planned had one or more of the adverse outcomes examined.
Kathryn Fitzpatrick, who led the study, said: "Our findings can be used to counsel women with a prior cesarean section and should be read in conjunction with the existing evidence on the increased risk of maternal morbidity severe in later pregnancies are associated with elective caesarean section repeat".
In his opinion, "more studies are needed to confirm these findings and to investigate the longer-term results associated with cesarean sections or multiple attempts at vaginal birth after a previous c-section".Updated Date: 25 September 2019, 18:02