title: Pregnancy outcomes of induced labor in women with previous cesarean section: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review the literature about maternal and neonatal outcomes following induction of labor (IOL) and spontaneous labor (SL) in women with previous cesarean section (PCS).
  
  
  METHODS
  PubMed, Medline, EMBASE, Cochrane library searches; January 2000-February 2013.
  
  
  METHODS
  women attempting labor after PCS, singleton term pregnancies. Women undergoing IOL were compared with women in SL. Method for induction, mode of delivery, uterine rupture/dehiscence, post-partum hemorrhage, emergency hysterectomy and any maternal or neonatal morbidity and mortality were analyzed. MOOSE guidelines were followed. Interstudies heterogeneity was tested. A random effect model was generated if heterogeneity was >25 %. Pooled odds ratio with 95 % confidence interval (OR, 95 % CI) were calculated.
  
  
  RESULTS
  Eight articles included 4,038 women with IOL (23.2 %) and 13,374 women with SL (76.8 %). IOL was associated with a lower incidence of vaginal delivery (OR 0.66; 95 % CI 0.55-0.80) and higher rates of cesarean section (OR 1.52; 95 % CI 1.26-1.83), uterine rupture/dehiscence (OR 1.62; 95 % CI 1.13-2.31), and post-partum hemorrhage (OR 1.57; 95 % CI 1.20-2.04), although hysterectomy was similar between the two groups (OR 2.60; 95 % CI 0.52-13.1). Neonatal morbidity was similar after IOL or SL (OR 1.13; 95 % CI 0.75-1.69).
  
  
  CONCLUSIONS
  Induction of labor increases the risk of uterine rupture/dehiscence and of repeat cesarean section.
authors.affiliation: Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
authors.forename: A C
authors.initials: AC
authors.lastname: Rossi
authors.forename: Federico
authors.initials: F
authors.lastname: Prefumo
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D007743:Labor, Obstetric / Q000502:physiology*; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012306:Risk; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology