Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth.
BACKGROUND
When a woman has had a previous caesarean birth and requires induction of labour in a subsequent pregnancy, there are two options for her care: elective repeat caesarean or planned induction of labour. While there are risks and benefits for both elective repeat caesarean birth and planned induction of labour, current sources of information are limited to non-randomised cohort studies. Studies designed in this way have significant potential for bias and consequently conclusions based on these results are limited in their reliability and should be interpreted with caution.


OBJECTIVE
To assess, using the best available evidence, the benefits and harms of elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1) and PubMed (1966 to January 2006).


METHODS
Randomised controlled trials with reported data that compared outcomes in mothers and babies who planned a repeat elective caesarean section with outcomes in women who planned induction of labour, where a previous birth had been by caesarean.


METHODS
There was no data extraction performed.


RESULTS
There were no randomised controlled trials identified.


CONCLUSIONS
Planned elective repeat caesarean section and planned induction of labour for women with a prior caesarean birth are both associated with benefits and harms. Evidence for these care practices is drawn from non-randomised studies, associated with potential bias. Any results and conclusions must therefore be interpreted with caution. Randomised controlled trials are required to provide the most reliable evidence regarding the benefits and harms of both planned elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth.
Dodd
J M
JM
The University of Adelaide, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, Women's and Children's Hospital, 72 King William Road, Adelaide, South Australia, Australia. jodie.dodd@adelaide.edu.au
Crowther
C A
CA
D017604:Cesarean Section, Repeat / Q000009:adverse effects; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects; D011247:Pregnancy; D016064:Vaginal Birth after Cesarean