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Induction of labor at second delivery subsequent to a primary cesarean: is stage of labor at previous cesarean a factor?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Parturients with a history of a cesarean delivery (CD) in the first delivery (P1), undergoing induction of labor (IOL) in the subsequent delivery (P2) are at increased risk for obstetric complications. The primary aim was to study if “the stage of labor” at previous cesarean (elective/latent/first/second) is associated with a successful IOL. The secondary aim was to search for other obstetric characteristics associated with a successful IOL.

Methods

A retrospective longitudinal follow-up study in a large tertiary medical center. All parturients at term who underwent IOL at P2 with a singleton fetus in cephalic presentation, with a prior CD, between the years 2006 and 2014 were included. A univariate analysis was performed including the stage of labor at previous cesarean, birth weight of newborn at P1 and P2, gestational week of delivery at P2, time of interpregnancy interval, indication and mode of IOL, epidural analgesia and augmentation of labor at P2. Significant factors were incorporated in a multivariate logistic regression model.

Results

During the study period, 150 parturients underwent IOL (P2) subsequent to a previous CD (P1). VBAC was achieved in 78 (52%). We found no association between the stages of labor in which the previous CD was performed to a successful IOL. Applying the multivariate logistic regression revealed that augmentation of labor with oxytocin, OR 4.17, [1.73–10.05], epidural analgesia OR 3.30 [1.12–9.73] and birth weight (P2) < 4000 g, OR 5.88, [1.11–33.33] were associated with a successful IOL.

Conclusion

The stage of labor at previous CD should not be incorporated among the variables found to be associated with a successful IOL. As a result of our findings, clinician's will be able to adjust a personalized consult prior to initiating IOL.

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Funding

This study was not funded by any organization.

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Author notes

  1. Donna Amitai, Reut Rotem: equal contribution to manuscript.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, 12 Bayit Shaare Zedek Medical Center, Affiliated with the Hebrew University Medical School of Jerusalem, 91031, Jerusalem, Israel

    Donna Amitai, Reut Rotem, Misgav Rottenstreich, Maayan Bas-Lando, Arnon Samueloff, Sorina Grisaru-Granovsky & Orna Reichman

Authors
  1. Donna Amitai
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  2. Reut Rotem
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  3. Misgav Rottenstreich
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  4. Maayan Bas-Lando
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  5. Arnon Samueloff
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  6. Sorina Grisaru-Granovsky
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  7. Orna Reichman
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Contributions

DA: protocol development, data collection and management, data analysis, and manuscript writing/editing. RR: protocol development, data collection and management, data analysis, and manuscript writing/editing. MR: protocol development and manuscript writing/editing. MB-L: data collection and management, manuscript. AS: data collection and management, data analysis SG-G: data collection and management, data analysis OR: protocol development, data collection and management, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Misgav Rottenstreich.

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Conflict of interest

The authors declare that they have nothing to disclose and that they have no financial or non-financial conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors. The Shaare Zedek Medical Center institutional review board approved the study (0038-16), with waiver of informed consent due to the retrospective, observational design of the study.

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Amitai, D., Rotem, R., Rottenstreich, M. et al. Induction of labor at second delivery subsequent to a primary cesarean: is stage of labor at previous cesarean a factor?. Arch Gynecol Obstet 303, 659–663 (2021). https://doi.org/10.1007/s00404-020-05776-z

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  • DOI: https://doi.org/10.1007/s00404-020-05776-z

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