title: The outcome and cumulative morbidity associated with the second and third postcesarean delivery.
abstract: The purpose of this study was to compare the outcome and cumulative morbidity among women who delivered twice after a cesarean delivery (CD), and who underwent in the second delivery either a trial of labor (TOL) or planned cesarean delivery (PCD). Eligible women (N = 399) were divided into two groups based on first post-CD: a TOL (n = 304) or PCD (n = 95). Women attempting a TOL were successful in 70 and 75% in the first and second post-CD, respectively. All participants undergoing a PCD subsequently had a third PCD. The overall morbidity was 8.4 and 5.3% among PCD and TOL groups, respectively ( P = 0.258). Women attempting a TOL after a previous CD had a 70 and 53% likelihood for at least one successful or two successful vaginal births in the two subsequent deliveries, respectively. No significant difference was documented between the groups regarding the cumulative morbidity.
authors.affiliation: Department of Obstetrics & Gynecology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Gonen
authors.forename: Shlomi
authors.initials: S
authors.lastname: Barak
authors.forename: Viki
authors.initials: V
authors.lastname: Nissenblat
authors.forename: Gonen
authors.initials: G
authors.lastname: Ohel
mesh_terms: D000328:Adult; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009017:Morbidity; D010298:Parity; D011247:Pregnancy; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*