title: Vaginal birth after cesarean delivery: an historic cohort cost analysis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the relative cost-effectiveness of attempted vaginal birth after cesarean delivery compared with elective repeat cesarean delivery.
  
  
  METHODS
  We performed an historic cohort analysis of women with a single prior cesarean delivery who were delivered at our institution during 1999. Inclusion criteria were > or =36 weeks' gestation and carrying a live, singleton fetus with no antenatally diagnosed anomalies. The primary outcome variable was mean cost of hospital care for mother-infant pairs, as obtained from the hospital's Clinical Resources Department.
  
  
  RESULTS
  The cohort consisted of 204 mother-infant pairs, 65 in the elective repeat cesarean group and 139 in the attempted vaginal birth group. Mean cost of care was higher for mothers ($4155 vs $3675;P <.001), neonates ($1794 vs $1187; P =.03), and mother-infant pairs ($5949 vs $4863; P =.001) for the elective repeat cesarean group compared with the attempted vaginal delivery group.
  
  
  CONCLUSIONS
  In women with a single prior cesarean delivery, a trial of labor is more cost-effective than an elective repeat cesarean delivery.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and Shands Hospital, University of Florida, Gainesville, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: DiMaio
authors.forename: Rodney K
authors.initials: RK
authors.lastname: Edwards
authors.forename: Tammy Y
authors.initials: TY
authors.lastname: Euliano
authors.forename: R William
authors.initials: RW
authors.lastname: Treloar
authors.forename: Amelia C
authors.initials: AC
authors.lastname: Cruz
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000191:economics; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007231:Infant, Newborn; D016064:Vaginal Birth after Cesarean / Q000191:economics*