Delivery after previous cesarean: short-term perinatal outcomes.
Women must often choose between a vaginal birth after previous cesarean and elective repeat cesarean delivery. Short-term risks of vaginal birth after cesarean can be potentially catastrophic in the setting of uterine rupture. Although randomized controlled trials comparing these 2 modes of delivery are lacking, observational studies suggest an increased risk of perinatal mortality and hypoxic-ischemic encephalopathy in infants whose mothers undergo a trial of labor. These rare risks compete with more common, albeit less severe, short-term risks associated with elective repeat cesarean delivery, with a particular emphasis on increased respiratory morbidities. Further studies are needed to identify potential strategies to improve perinatal outcomes and help guide physicians and patients in choosing optimal methods of delivery.
Patel
Ravi M
RM
Department of Pediatrics, Division of Neonatology, Emory University School of Medicine, Atlanta, GA 30322, USA.
Jain
Lucky
L
D001720:Birth Injuries / Q000453:epidemiology; D017604:Cesarean Section, Repeat / Q000009:adverse effects* / Q000639:trends; D015975:Consensus Development Conferences, NIH as Topic; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D009316:National Institutes of Health (U.S.); D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012307:Risk Factors; D014219:Trial of Labor; D014481:United States; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects* / Q000639:trends