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Guise JM, Eden K, Emeis C, et al. Vaginal Birth After Cesarean: New Insights. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Mar. (Evidence Reports/Technology Assessments, No. 191.)

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Vaginal Birth After Cesarean: New Insights.

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Appendix RDetailed Infection Table

Table R-1Infection rates for trial of labor versus elective repeat cesarean delivery

Author, yearStudy descriptionNFeverFever per 10,000Endometritis Chorio-amnionitisEndometritis or Chorio-amnionitis per 10,000Wound/OtherWound/Other per 10,000
Term gestational age
Eriksen, 19891Retrospective cohort military base139TOL: 4/71 (5.6%)
ERCD: 7/68 (10.2%) (p:NS)
TOL: 560
ERCD: 1020 (p:NS)
TOL: 2/71 (2.8%)
ERCD: 1/68 (1.5%) (p:NS)
TOL: 280
ERCD: 150
Not reported
Hook, 19972Prospective cohort level 1, 2, & 3 hospital included989Maternal fever
TOL: 38/492 (8%)
ERCD: 0/497 (0%) (p=<0.0002)
Maternal fever
TOL: 80
ERCD: 0 (p=<0.0002)
Not reportedNot reportedNot reportedNot reported
Loebel,20043Retrospective cohort community teaching hospital1,408Not reportedNot reportedNot reportedNot reported“Infection”
ERCD: 11/481 (1.9%)
VBAC 14/749 (2.3%)
TOL-CD 9/178 (5.1%) (p:NS)
Infection”
ERCD: 190
VBAC 230
TOL-CD 510 (p:NS)
Spong, 20074MFMU network cohort 19 university hospitals39,117Not reportedNot reportedTOL: 442/15,323 (2.9%)
ERCD no labor: 260/14,993(1.7 %)
ERCD + labor: 101/2721 (3.7%)
IRCD no labor 137/5002 (2.7%)
IRCD + labor: 54/1078 (5.0%)
TOL: 290
ERCD no labor: 170
ERCD + labor: 370
IRCD no labor 270
IRCD + labor: 500
Not reportedNot reported
Wen, 20045Retrospective cohort Canadian registry ICD-9 codes308,755Not reportedNot reportedNot reportedNot reported“Postpartum Infection”
TOL: 487/128,960 (0.38%)
ERCD: 837/179,795 (0.47%);
Adjusted odds ratio: 0.86 (0.77–0.97)
“Postpartum Infection”
TOL: 380
ERCD: 470
Adjusted odds ratio: 0.86 (0.77–0.97)
All gestational ages
Bais, 20016Prospective cohort Netherlands regional hospital252TOL: 16/184 (9%)
ERCD: 7/68 (10%)
TOL: 900
ERCD: 1000
Not reportedNot reportedNot reportedNot reported
Cahill, 20067Retrospective cohort 16 university & community hospitals6,619TOL: 329/5041 (6.52%)
ERCD: 294/1578(18.63 %)
TOL: 652
ERCD: 1863
Not reportedNot reportedNot reportedNot
reported
Durnwald, 20048Retrospective cohort university hospital768TOL: 27/522(5.2%)
VBAC: 7/344(2.0%)
TOL-CD: 20/178 (11.2%)
ERCD: 6/246 (2.4%)
TOL: 520
VBAC: 200
TOL-CD: 1120
ERCD: 240
Chorio- amnionitis
TOL: 31/522(5.9%)
VBAC: 18/344(5.2%)
TOL-CD: 13/178(7.3%)
ERCD: 0/246(0%)

Endometritis
TOL: 24/522 (4.6%)
VBAC: 7/344(2%)
TOL-CD: 17/178(9.6%)
ERCD: 5/246(2%)
Chorio- amnionitis
TOL: 590
VBAC: 520
TOL-CD: 730
ERCD: 0

Endometritis
TOL: 460
VBAC: 200
TOL-CD: 960
ERCD: 200
Not reportedNot reported
Flamm, 19949Prospective cohort 10 Kaiser hospital in California7,229TOL: 638/5022 (12.7%)
ERCD: 362/2208 (16.4%)
TOL: 1270
ERCD: 1640
Not reportedNot reportedNot reportedNot reported
McMahon, 199610Retrospective cohort population based longitudinal study Canada6,138TOL: 171/3424 (5.3%)
ERCD: 185/2889 (6.4%)
TOL: 530
ERCD: 640
Not reportedNot reportedWound
TOL 43/3424 (1.3%)
ERCD 63/2889 (2.2%)
Wound
TOL 130
ERCD 220
Phelan, 198711Prospective Cohort University hospital ≥ 2 prior CD only2,643Planned TOL 159/1,796 (8.9%)*
VBAC: 53/1465 (3.6%)
TOL-CD: 106/331 (32%)
No Planned TOL 163/847 (19.2%)
VBAC: 4/69 (5.8%)
ERCD: 56/314 (18%)
IRCD: 103/464 (22%)
Planned TOL 890*
VBAC: 360
TOL-CD: 320
No Planned
TOL 1920
VBAC: 580
ERCD: 1800
IRCD: 2200
Not reportedNot reportedNot reportedNot reported
Kugler, 200812Retrospective cohort Israel University grand multiparous1,102IRCD 10/328 (3%), TOL: 9/619(1.5%), VBAC: 1/155(0.6%)IRCD 300
TOL: 150
VBAC: 60
Amnionitis
IRCDa 4/328(1.2%)
TOL: 5/619 (0.8%), VBAC: 14/155 (9.0%)
Amnionitis
IRCDa 120
TOL: 80
VBAC: 900
Not reportedNot reported
Eglinton, 198413Retrospective cohort university hospital871VBAC: 6/240(2.5%)
TOL-CD: 27/136 (19.8%)
ERCD: 176/495 (35.5%)
VBAC: 250
TOL-CD: 1980
ERCD: 3550
Not reportedNot reportedNot reportedNot reported
Chauhan, 20011469Not reportedNot reportedTOL: 9/30 (30%)
ERCD: 7/39 (18%)
TOL: 300
ERCD: 1800
Wound
TOL: 8/30(27%)
ERCD: 3/39(8%)
Wound
TOL: 2700
ERCD: 800
Hibbard, 200115Prospective cohort university hospital2,450Not reportedNot reportedEndometritis
ERCD: 38/431 (8.8%)
TOL: 108/1,324 (8.2%)
VBAC: 31/908 (3.4%)
TOL-CD: 77/416 (18.5%)
Chorio- amnionitis
ERCD: 18/431 (4.2%)
TOL: 169/1,324 (12.8%)
VBAC: 102/908 (11.2%)
TOL-CD: 67/416 (16%)
Endometritis
ERCD: 880
TOL: 820
VBAC: 340
TOL-CD: 1850
Chorio- amnionitis
ERCD: 420
TOL: 1280
VBAC: 1120
TOL-CD: 1600
Not reportedNot reported
Martin, 198316Prospective cohort 2 university centers709Not reportedNot reportedEndometritis
VBAC: 1/101(1%)
TOL-CD: 7/61 (11.5%)
ERCD: 42/547 (7.7%)
TOL: 8/162 = 4.9%
Endometritis
VBAC: 100
TOL-CD: 1150
ERCD: 770
TOL: 490
Wound
VBAC: 0/101
TOL-CD: 3/61 (4.9%)
ERCD: 12/547 (2.2%)
Any TOL: 3/162 (1.9%)
Pulmonary:
VBAC: 5/101 (5%)
TOL-CD: 1/61 (1.6%)
ERCD: 31/547 (5.7%)
Other:
VBAC: 3/101 (3%)
TOL-CD: 2/61 (3.2%)
ERCD:36/547(6.6%)
Wound
VBAC: 0
TOL-CD: 490
ERCD: 220
Any TOL: 190
Pulmonary
VBAC: 500
TOL-CD: 160
ERCD: 570
Other:
VBAC: 300
TOL-CD: 320
ERCD: 660
*

p < .05;

includes both ERCD as well as emergency CD

Abbreviations: ERCD=elective repeat cesarean delivery; IRCD=indicated repeat cesarean delivery; NS=not significant; TOL=trial of labor; TOL-CD=trial of labor followed by a cesarean delivery; UTI=urinary tract infection; VBAC=vaginal birth after cesarean

References

1.
Eriksen NL, Buttino L Jr. Vaginal birth after cesarean: a comparison of maternal and neonatal morbidity to elective repeat cesarean section. Am J Perinatol. 1989;6(4):375–379. [PubMed: 2789534]
2.
Hook B, Kiwi R, Amini SB, Fanaroff A, Hack M. Neonatal morbidity after elective repeat cesarean section and trial of labor. Pediatrics. 1997;100(3 Pt 1):348–353. [PubMed: 9282704]
3.
Loebel G, Zelop CM, Egan JFX, Wax J. Maternal and neonatal morbidity after elective repeat Cesarean delivery versus a trial of labor after previous Cesarean delivery in a community teaching hospital. J Matern Fetal Neonatal Med. 2004;15(4):243–246. [PubMed: 15280132]
4.
Spong CY, Landon MB, Gilbert S, et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol. 2007;110(4):801–807. [PubMed: 17906012]
5.
Wen SW, Rusen ID, Walker M, et al. Comparison of maternal mortality and morbidity between trial of labor and elective cesarean section among women with previous cesarean delivery. Am J Obstet Gynecol. 2004;191(4):1263–1269. [PubMed: 15507951]
6.
Bais JM, van der Borden DM, Pel M, et al. Vaginal birth after caesarean section in a population with a low overall caesarean section rate. Eur J Obstet Gynecol Reprod Biol. 2001;96(2):158–162. [PubMed: 11384799]
7.
Cahill AG, Stamilio DM, Odibo AO, et al. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery? Am J Obstet Gynecol. 2006;195(4):1143–1147. [PubMed: 16846571]
8.
Durnwald C, Mercer B. Vaginal birth after Cesarean delivery: predicting success, risks of failure. J Matern Fetal Neonatal Med. 2004;15(6):388–393. [PubMed: 15280110]
9.
Flamm BL, Goings JR, Liu Y, Wolde-Tsadik G. Elective repeat cesarean delivery versus trial of labor: a prospective multicenter study. Obstet Gynecol. 1994;83(6):927–932. [PubMed: 8190433]
10.
McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF. Comparison of a trial of labor with an elective second cesarean section.[see comment] N Engl J Med. 1996;335(10):689–695. [PubMed: 8703167]
11.
Phelan JP, Clark SL, Diaz F, Paul RH. Vaginal birth after cesarean. Am J Obstet Gynecol. 1987;157(6):1510–1515. [PubMed: 3425654]
12.
Kugler E, Shoham-Vardi I, Burstien E, Mazor M, Hershkovitz R. The safety of a trial of labor after cesarean section in a grandmultiparous population. Arch Gynecol Obstet. 2008;277(4):339–344. [PubMed: 17957377]
13.
Eglinton GS, Phelan JP, Yeh S, Diaz FP, Wallace TM, Paul RH. Outcome of a trial of labor after prior cesarean delivery. J Reprod Med. 1984;29(1):3–8. [PubMed: 6708017]
14.
Chauhan SP, Magann EF, Carroll CS, Barrilleaux PS, Scardo JA, Martin JN Jr. Mode of delivery for the morbidly obese with prior cesarean delivery: vaginal versus repeat cesarean section. Am J Obstet Gynecol. 2001;185(2):349–354. [PubMed: 11518890]
15.
Hibbard JU, Ismail MA, Wang Y, Te C, Karrison T. Failed vaginal birth after a cesarean section: how risky is it? I. Maternal morbidity. Am J Obstet Gynecol. 2001;184(7):1365–1371. discussion 1371–1363. [PubMed: 11408854]
16.
Martin JN Jr, Harris BA Jr, Huddleston JF, et al. Vaginal delivery following previous cesarean birth. Am J Obstet Gynecol. 1983;146(3):255–263. [PubMed: 6859134]

p < .05;

includes both ERCD as well as emergency CD

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