Induction of labour for women with a previous Caesarean birth: a systematic review of the literature.
OBJECTIVE
To compare the benefits and harms of planned elective repeat Caesarean section with induction of labour and to assess different methods of cervical ripening and induction of labour for women with a previous Caesarean birth who require induction of labour in a subsequent pregnancy.


METHODS
The Cochrane controlled trials register and MEDLINE (1966-current) were searched using the following terms: vaginal birth after C(a)esare(i)an, trial of labo(u)r, elective C(a)esare(i)an, C(a)esare(i)an repeat, induction of labo(u)r, prostaglandins, prostaglandin E(2), misoprostol, prostaglandin E(1) analogs, mifepristone, oxytocin, Syntocinon, randomis(z)ed controlled trial, randomis(z)ed trial and clinical trial, to identify all published randomised controlled trials with reported data comparing outcomes for women and infants who have a planned elective repeat Caesarean section with induction of labour; and different methods of induction of labour, where a prior birth was by Caesarean section.


RESULTS
There were no randomised controlled trials identified where women with a prior Caesarean birth, whose labour required induction in a subsequent pregnancy, compared elective repeat Caesarean section with induction of labour. There were three randomised controlled trials identified in which women with a prior Caesarean section were allocated to different methods of induction of labour - vaginal prostaglandin E(2) versus intravenous oxytocin; mifepristone versus placebo; and vaginal misoprostol versus intravenous oxytocin. These studies varied considerably in the methods used and meta-analysis was not appropriate.


CONCLUSIONS
There is a paucity of safety information for induction of labour agents in the women with a scarred uterus, and caution should be exercised in their use.
Dodd
Jodie
J
Department of Obstetrics and Gynaecology, The University of Adelaide, 72 King William Road, North Adelaide 5006, South Australia, Australia. jodie.dodd@adelaide.edu.au
Crowther
Caroline
C
D017604:Cesarean Section, Repeat / Q000009:adverse effects* / Q000592:standards; D005260:Female; D006801:Humans; D008429:Maternal Welfare; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects* / Q000592:standards