title: Trial of labour after caesarean (TOLAC) is associated with increased risk for instrumental delivery.
abstract: We compared the rates of instrumental delivery in a cohort of nulliparous women at term (n = 19,416), to primiparous women who attempted labour after prior caesarean (TOLAC) (n = 1747). The rate of instrumental deliveries was higher in the TOLAC group compared to nulliparous gravidas (17.3 vs. 15% respectively, p = 0.001). The difference was more prominent for women who eventually had successful vaginal delivery (TOLAC: 23.9% vs.
  
  
  METHODS
  17.1%, p < 0.0001 respectively). Based on our results, previous caesarean whether urgent or elective was associated with an increased risk of instrumental delivery in the subsequent pregnancy.
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Rotem
authors.initials: R
authors.lastname: Inbar
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaaki
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Kalter
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Gat
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sivan
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
authors.affiliation: a Department of Obstetrics and Gynecology , Sheba Medical Center, Tel-Hashomer , Israel.|b Sackler Medical School, Tel Aviv University , Tel-Aviv , Israel.
authors.forename: Israel
authors.initials: I
authors.lastname: Hendler
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000209:etiology / Q000601:surgery*; D010298:Parity; D011247:Pregnancy; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*
keywords: TOLAC; VBAC; caesarean; instrumental delivery