Vaginal Birth after Cesarean Section: Risk of Uterine Rupture with Labor Induction

Joseph G Ouzounian; David A Miller; Christy J Hiebert; Leah R Battista; Richard H Lee

doi:10.1055/s-0031-1275386

American Journal of Perinatology, Table of Contents

Am J Perinatol 2011; 28(8): 593-596
DOI: 10.1055/s-0031-1275386

Vaginal Birth after Cesarean Section: Risk of Uterine Rupture with Labor Induction

Joseph G. Ouzounian¹ , David A. Miller¹ , Christy J. Hiebert¹ , Leah R. Battista² , Richard H. Lee¹

¹Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles
²Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Baldwin Park, California

Abstract

ABSTRACT

We assessed the rate of uterine rupture in patients undergoing labor induction for attempted vaginal birth after cesarean (VBAC). A retrospective study was performed of data from a computerized database. Deliveries from January 1, 1998, to June 30, 2001, in the Southern California Kaiser Permanente system were reviewed and various perinatal characteristics analyzed. A total of 16,218 patients had a prior low transverse cesarean section. Of these, 6832 (42.1%) had a trial of labor. Successful VBAC occurred in 86% of patients with spontaneous onset of labor and 66% of patients with labor induction (p < 0.001). The uterine rupture rate was not different between patients with spontaneous or induced labor (1.0% versus 1.2%, p = 0.51). Similarly, there was no significant difference between oxytocin or prostaglandin E2 induction (1.4% versus 1.0%, p = 0.59). In our study, labor induction did not appear to increase the risk of uterine rupture in women attempting VBAC.

KEYWORDS

Labor induction - VBAC - prior cesarean section - TOLAC

Full Text

References

REFERENCES

1 Miller D A, Diaz F G, Paul R H. Vaginal birth after cesarean: a 10-year experience. Obstet Gynecol. 1994; 84 255-258
2 Stone J L, Lockwood C J, Berkowitz G et al.. Use of cervical prostaglandin E2 gel in patients with previous cesarean section. Am J Perinatol. 1994; 11 309-312
3 Paul R H, Phelan J P, Yeh S Y. Trial of labor in the patient with a prior cesarean birth. Am J Obstet Gynecol. 1985; 151 297-304
4 Flamm B L, Dunnett C, Fischermann E, Quilligan E J. Vaginal delivery following cesarean section: use of oxytocin augmentation and epidural anesthesia with internal tocodynamic and internal fetal monitoring. Am J Obstet Gynecol. 1984; 148 759-763
5 Phelan J P, Eglinton G S, Horenstein J M, Clark S L, Yeh S. Previous cesarean birth. Trial of labor in women with macrosomic infants. J Reprod Med. 1984; 29 36-40
6 Pruett K M, Kirshon B, Cotton D B, Poindexter III A N. Is vaginal birth after two or more cesarean sections safe?. Obstet Gynecol. 1988; 72 163-165
7 Strong Jr T H, Phelan J P, Ahn M O, Sarno Jr A P. Vaginal birth after cesarean delivery in the twin gestation. Am J Obstet Gynecol. 1989; 161 29-32
8 Sarno Jr A P, Phelan J P, Ahn M O, Strong Jr T H. Vaginal birth after cesarean delivery. Trial of labor in women with breech presentation. J Reprod Med. 1989; 34 831-833
9 Menacker F, Declercq E, Macdorman M F. Cesarean delivery: background, trends, and epidemiology. Semin Perinatol. 2006; 30 235-241
10 Lydon-Rochelle M, Holt V L, Easterling T R, Martin D P. Risk of uterine rupture during labor among women with a prior cesarean delivery. N Engl J Med. 2001; 345 3-8
11 Macones G A, Peipert J, Nelson D B et al.. Maternal complications with vaginal birth after cesarean delivery: a multicenter study. Am J Obstet Gynecol. 2005; 193 1656-1662
12 Landon M B, Hauth J C, Leveno K J et al. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004; 351 2581-2589
13 ACOG Practice Bulletin No. 115, August. Vaginal birth after previous cesarean delivery. Washington, DC: American College of Obstetricians and Gynecologists; 2010
14 Grobman W A, Gilbert S, Landon M B et al.. Outcomes of induction of labor after one prior cesarean. Obstet Gynecol. 2007; 109 (2 Pt 1) 262-269
15 Ravasia D J, Wood S L, Pollard J K. Uterine rupture during induced trial of labor among women with previous cesarean delivery. Am J Obstet Gynecol. 2000; 183 1176-1179
16 Zelop C M, Shipp T D, Repke J T, Cohen A, Caughey A B, Lieberman E. Uterine rupture during induced or augmented labor in gravid women with one prior cesarean delivery. Am J Obstet Gynecol. 1999; 181 882-886
17 ACOG Committee Opinion No. 271, April. Induction of labor for vaginal birth after cesarean delivery. Washington, DC: American College of Obstetricians and Gynecologists; 2002
18 Yogev Y, Ben-Haroush A, Lahav E, Horowitz E, Hod M, Kaplan B. Induction of labor with prostaglandin E2 in women with previous cesarean section and unfavorable cervix. Eur J Obstet Gynecol Reprod Biol. 2004; 116 173-176
19 ACOG Committee Opinion No. 342, August. Induction of labor for vaginal birth after cesarean delivery. Washington, DC: American College of Obstetricians and Gynecologists; 2006
20 National Institutes of Health .National Institutes of Health Consensus Development Conference Statement. NIH Consensus Development Conference: Vaginal Birth After Cesarean: New Insights. Draft statement. March 26, 2010. Available at: http://consensus.nih.gov/2010/images/vbac/vbac_statement.pdf Accessed May 26, 2010
21 Wing D A, Lovett K, Paul R H. Disruption of prior uterine incision following misoprostol for labor induction in women with previous cesarean delivery. Obstet Gynecol. 1998; 91 (5 Pt 2) 828-830
22 Aslan H, Unlu E, Agar M, Ceylan Y. Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery. Eur J Obstet Gynecol Reprod Biol. 2004; 113 45-48

Joseph G OuzounianM.D.

LAC + USC Medical Center, 1200 N. State Street

IRD 220, Los Angeles, CA 90033

Email: jouzouni@usc.edu