title: Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru.
abstract: OBJECTIVE
  To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery.
  
  
  METHODS
  This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery.
  
  
  RESULTS
  Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7).
  
  
  CONCLUSIONS
  Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.
authors.affiliation: Department of Obstetrics and Gynecology, Instituto Nacional Materno-Perinatal, Lima, Peru.
authors.forename: Walter Ricardo
authors.initials: WR
authors.lastname: Ventura Laveriano
authors.forename: Conny Elizabeth Nazario
authors.initials: CE
authors.lastname: Redondo
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010568:Peru; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016064:Vaginal Birth after Cesarean; D055815:Young Adult