Archives of Gynecology and Obstetrics

, Volume 287, Issue 6, pp 1075–1079

Second stage disorders in patients following a previous cesarean section: vacuum versus repeated cesarean section

  • Roy Kessous
  • Dan Tirosh
  • Adi Y. Weintraub
  • Neta Benshalom-Tirosh
  • Ruslan Sergienko
  • Eyal Sheiner
Maternal-Fetal Medicine

Abstract

Objective

To investigate whether vacuum extraction due to failure of labor to progress (dystocia) during the second stage in a delivery following a previous cesarean section (CS) is related to increased adverse maternal and perinatal outcomes as compared with repeated CS.

Study design

A retrospective cohort study of pregnancy and delivery outcomes of patients in their second deliveries attempting a vaginal birth after cesarean (VBAC) following one CS was conducted. Patients who delivered by vacuum extraction were compared with patients who underwent a repeated CS for failure of labor to progress during the second stage.

Results

During the study period, 319 patients with a previous CS suffered from a prolonged second stage of labor in their second delivery. Of these, 184 underwent vacuum extraction and 135 patients underwent a repeated CS. No significant differences in relevant pregnancy complications such as perineal lacerations, uterine rupture, and post-partum hemorrhage and perinatal outcomes were noted between the groups. There were no cases of perinatal mortality in our study.

Conclusion

When managing second stage labor disorders, vacuum extraction does not seem to be an unsafe procedure in patients with a previous CS.

Keywords

Cesarean section Vacuum extraction Prolonged second stage Vaginal birth after cesarean 

References

  1. 1.
    MacDorman MF, Declercq E, Menacker F (2011) Recent trends and patterns in cesarean and vaginal birth after cesarean (VBAC) deliveries in the United Sates. Clin Perinatol 38:179–192PubMedCrossRefGoogle Scholar
  2. 2.
    National vital statistics reports—births: final data for 2008, published 8 Dec 2010, Vol 59, No. 1, NCHS, CDCGoogle Scholar
  3. 3.
    Bailey PE (2005) The disappearing art of instrumental delivery: time to reverse the trend. Int J Gynaecol Obstet 91(1):89–96PubMedCrossRefGoogle Scholar
  4. 4.
    McMahon MJ, Luther ER, Bowes WA, Olshan AF (1996) Comparison of a trial of labor with an elective second cesarean section. N Engl J Med 335:689–695PubMedCrossRefGoogle Scholar
  5. 5.
    Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP (2001) Risk of uterine rupture during labor among women with a prior cesarean section. N Engl J Med 345:3–8PubMedCrossRefGoogle Scholar
  6. 6.
    Landon MB, Hauth JC, Leveno KJ et al (2004) Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med 351:2581–2589PubMedCrossRefGoogle Scholar
  7. 7.
    Phillips E, McGrath P, Vaughan G (2010) ‘I wanted desperately to have a natural birth’: mothers’ insights on vaginal birth after caesarean (VBAC). Contemp Nurse 34:77–84CrossRefGoogle Scholar
  8. 8.
    Majoko F, Gardener G (2008) Trial of instrumental delivery in theatre versus immediate caesarean section for anticipated difficult assisted births. Cochrane Database Syst Rev (4). doi:10.1002/14651858.CD005545.pub2
  9. 9.
    Contag SA, Clifton RG, Bloom SL, Spong CY, Varner MW, Rouse DJ, Ramin SM, Caritis SN, Peaceman AM, Sorokin Y, Sciscione A, Carpenter MW, Mercer BM, Thorp JM Jr, Malone FD, Iams JD (2010) Neonatal outcomes and operative vaginal delivery versus cesarean delivery. Am J Perinatol 27(6):493–499PubMedCrossRefGoogle Scholar
  10. 10.
    Friedman EA (1954) The graphic analysis of labor. Am J Obstet Gynecol 68:1568–1575PubMedGoogle Scholar
  11. 11.
    Feinstein U, Sheiner E, Levy A, Hallak M, Mazor M (2002) Risk factors for arrest of descent during the second stage of labor. Int J Gynaecol Obstet 77(1):7–14PubMedCrossRefGoogle Scholar
  12. 12.
    Ebulue V, Vadalkar J, Cely S, Dopwell F, Yoong W (2008) Fear of failure: are we doing too many trials of instrumental delivery in theatre? Acta Obstet Gynecol Scand 87(11):1234–1238PubMedCrossRefGoogle Scholar
  13. 13.
    Silberstein T, Wiznitzer A, Katz M, Friger M, Mazor M (1998) Routine revision of uterine scar after cesarean section: has it ever been necessary? Eur J Obstet Gynecol Reprod Biol 78:29–32PubMedCrossRefGoogle Scholar
  14. 14.
    Kaplan B, Royburt M, Peled Y, Hirsch M, Hod M, Ovadia Y, Neri A (1994) Routine revision of uterine scar after prior cesarean section. Acta Obstet Gynecol Scand 73:473–475PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Roy Kessous
    • 1
  • Dan Tirosh
    • 1
  • Adi Y. Weintraub
    • 1
  • Neta Benshalom-Tirosh
    • 1
  • Ruslan Sergienko
    • 2
  • Eyal Sheiner
    • 1
  1. 1.Department of Obstetrics and Gynecology, Faculty of Health SciencesSoroka University Medical Center, Ben-Gurion University of the NegevBeer-ShevaIsrael
  2. 2.Epidemiology and Health Services EvaluationBen-Gurion University of the NegevBeer-ShevaIsrael

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