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Current evidence in the management of previous caesarean section: clinical review

  • Clinical Review
  • Published:
European Clinics in Obstetrics and Gynaecology

Abstract

The safety of women undergoing childbirth with prior caesarean delivery is a major public health concern. Most of the earlier studies focused on the success rate of vaginal birth after caesarean section; later focus shifted to maternal and neonatal safety, and presently, each factor that would influence the outcome of trial of labour is being considered on both the success and the safety of vaginal birth following caesarean delivery. The contribution of induction of labour to uterine rupture is not entirely clear. Although large multi-center randomised trials comparing planned elective repeat caesarean delivery vs vaginal delivery following prior caesarean delivery are required for conclusive evidence; current evidence suggests that, in properly selected women, vaginal birth can be safely achieved if adequate facilities to monitor the foetus and immediate caesarean can be performed. Unbiased evidence-based information should be given to patients in making decisions about mode of delivery based on individual characteristics. The purpose of this review is to understand each factor that would influence the success and safety of vaginal birth after caesarean delivery.

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Notes

  1. A system of assessing the general physical condition of a newborn infant based on a rating of 0, 1, or 2 for five criteria. The five scores are added together, with a perfect score being 10; Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.

Abbreviations

C-section:

Caesarean section

TOL:

Trial of labour

C-delivery:

Caesarean delivery

UR:

Uterine rupture

PPH:

Postpartum haemorrhage

ERCD:

Elective repeat caesarean delivery

VBAC:

Vaginal birth after caesarean

IOL:

Induction of labour

LUS:

Lower urerine segment

BMI:

Body mass index

CPD:

Cephalopelvic disproportion

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Authors and Affiliations

  1. Women’s Health Directorate, Blackpool Victoria Hospital, Whinney’s Hey Road, Blackpool, FY3 8NR, Lancashire, UK

    H. Muppala

  2. Royal Blackburn Hospital, Blackburn, UK

    S. K. Najia

  3. Burnley General Hospital, Burnley, UK

    F. R. Clarke

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  1. H. Muppala
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  2. S. K. Najia
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  3. F. R. Clarke
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Correspondence to H. Muppala.

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Muppala, H., Najia, S.K. & Clarke, F.R. Current evidence in the management of previous caesarean section: clinical review. Eur Clinics Obstet Gynaecol 3, 67–80 (2007). https://doi.org/10.1007/s11296-007-0065-x

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  • DOI: https://doi.org/10.1007/s11296-007-0065-x

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