title: Trial of labor after one previous cesarean delivery for multifetal gestation.
abstract: OBJECTIVE
  To estimate success rates and risks with a trial of labor after one previous cesarean delivery for multifetal gestation compared with one previous cesarean delivery for a singleton pregnancy.
  
  
  METHODS
  Patients from the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network Cesarean Registry with one previous cesarean delivery and a current term singleton pregnancy were identified. Cases had one previous cesarean delivery for a multifetal pregnancy. Controls had one previous cesarean delivery for a singleton pregnancy.
  
  
  RESULTS
  Of cases, 556 of 944 (58.9%) attempted a trial of labor. Of controls, 13,923 of 29,329 (47.5%) attempted a trial of labor. The trial of labor success rate was 85.6% among cases and 73.1% among controls (odds ratio 2.19, 95% confidence interval 1.72-2.78). Compared with trial of labor controls, cases had no statistically increased risk of transfusion, endometritis, intensive care unit admissions, uterine rupture, or perinatal complications. Cases in this analysis with a successful trial of labor were more likely to have previously had a successful vaginal birth after cesarean (37.1% compared with 14.1%, P<.001).
  
  
  CONCLUSIONS
  Women with one previous cesarean delivery for a multifetal gestation have high trial of labor success rates and low complication rates.
authors: Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA. mvarner@hsc.utah.edu
authors: Michael W
authors: MW
authors: Varner
authors: Elizabeth
authors: E
authors: Thom
authors: Catherine Y
authors: CY
authors: Spong
authors: Mark B
authors: MB
authors: Landon
authors: Kenneth J
authors: KJ
authors: Leveno
authors: Dwight J
authors: DJ
authors: Rouse
authors: Atef H
authors: AH
authors: Moawad
authors: Hyagriv N
authors: HN
authors: Simhan
authors: Margaret
authors: M
authors: Harper
authors: Ronald J
authors: RJ
authors: Wapner
authors: Yoram
authors: Y
authors: Sorokin
authors: Menachem
authors: M
authors: Miodovnik
authors: Marshall
authors: M
authors: Carpenter
authors: Alan
authors: A
authors: Peaceman
authors: Mary J
authors: MJ
authors: O'sullivan
authors: Baha M
authors: BM
authors: Sibai
authors: Oded
authors: O
authors: Langer
authors: John M
authors: JM
authors: Thorp
authors: Susan M
authors: SM
authors: Ramin
authors: Brian M
authors: BM
authors: Mercer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*