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

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
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Publication Date:
18 March 2011 (online)

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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