title: Mode of delivery in a subsequent pregnancy following previous instrumental delivery.
abstract: OBJECTIVE
  To assess mode of subsequent delivery in women with previous instrumental vaginal delivery.
  
  
  METHODS
  In this retrospective longitudinal study we followed women who underwent instrumental delivery. The study group included all consecutive parturient women who underwent an instrumental vaginal delivery during a 24-month period (1996-1999). We then identified women who had a subsequent delivery in our center until the end of the year 2010. The control group included women who had a spontaneous vaginal delivery from the same time.
  
  
  RESULTS
  During the index period we had 349 consecutive successful instrumental vaginal deliveries. Of those, 125 women had a subsequent delivery in our center (35.8%). In subsequent pregnancies, the spontaneous vaginal delivery rate was 76.8% and 90.4%; the instrumental delivery rate was 8.8% and 1.6%; and the cesarean rate was 14.4% and 8.0%, in the instrumental delivery, and spontaneous vaginal delivery groups, respectively (P<0.05). The odds ratio for a woman to undergo either an instrumental delivery or a cesarean after having an instrumental delivery in a previous pregnancy was 2.8 (95% confidence interval 1.4-5.9, P<0.05).
  
  
  CONCLUSIONS
  Women with a previous instrumental delivery are at an increased risk of requiring either an instrumental delivery or a cesarean section in a subsequent pregnancy compared with women with a previous spontaneous vaginal delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel. drslurie@hotmail.com
authors.forename: Samuel
authors.initials: S
authors.lastname: Lurie
authors.forename: Netanel
authors.initials: N
authors.lastname: Steinberg
authors.forename: Samer
authors.initials: S
authors.lastname: Tannus
authors.forename: Abraham
authors.initials: A
authors.lastname: Golan
authors.forename: Oscar
authors.initials: O
authors.lastname: Sadan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005113:Extraction, Obstetrical / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects; D055815:Young Adult