title: Safety and efficacy of attempted vaginal birth after cesarean beyond the estimated date of delivery.
abstract: OBJECTIVE
  To provide data regarding safety and efficacy for women attempting a trial of labor following earlier cesarean birth who have reached their due date.
  
  
  METHODS
  A computerized data base was analyzed to identify women who were at or beyond 40 weeks of gestation between January 1, 1995, and March 31, 1996. Ninety women attempted vaginal birth after cesarean (VBAC) during the study period; 90 controls were matched for age, race and parity. Delivery route and complications were outcome variables identified.
  
  
  RESULTS
  The rate of successful VBAC was 65.6% as compared to the 94.4% vaginal delivery rate among women who had not had a prior cesarean (P < .0001). Among women attempting VBAC, 62% of those who had no prior vaginal births successfully delivered vaginally, while 82% of women with one prior vaginal birth delivered vaginally (P < .0001). Women of greater parity were more successful at a trial of labor. Infectious morbidity was more common among women attempting VBAC than among those with no prior cesarean.
  
  
  CONCLUSIONS
  The patient and her family can be reassured that passing her due date does not alter the efficacy or safety of a trial of labor. No change in counseling is warranted simply due to the completion of 40 weeks' gestation.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill 27599-7570, USA. nancy_chescheir@med.unc.edu
authors.forename: C
authors.initials: C
authors.lastname: Callahan
authors.forename: N
authors.initials: N
authors.lastname: Chescheir
authors.forename: B D
authors.initials: BD
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003141:Communicable Diseases / Q000150:complications; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011273:Pregnancy, Prolonged; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects