Open AccessPerinatal outcome in births after a previous cesarean section at high trial of labor rates
Author(s) -
Lehmann Sjur,
Baghestan Elham,
Børdahl Per E.,
Irgens Lorentz M.,
Rasmussen Svein
Publication year - 2019
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13458
Subject(s) - medicine , apgar score , respiratory distress , population , obstetrics , pregnancy , birth weight , surgery , genetics , environmental health , biology
Trial of labor (TOLAC) is an option in most preganancies after a cesarean section The objective of the study was to compare perinatal outcome in TOLAC and non‐TOLAC deliveries in a population with high TOLAC rates. Material and methods This was a cohort study based on population data from the Medical Birth Registry of Norway. We included term, cephalic, single, second deliveries, 1989‐2009, after a first cesarean section (n = 43 422). TOLAC, TOLAC failure, non‐TOLAC deliveries, and after high‐risk and low‐risk pregnancies (no risk/any risk), were compared with respect to offspring mortality, 5‐minute Apgar score Apgar < 7 and < 4, transfer to a neonatal intensive care unit, and neonatal respiratory distress syndrome. Results Statistically significant differences were observed ( P <0.05). In the low‐risk group the offspring mortality was 2.3/1000 in TOLAC compared with 0.9/1000 in non‐TOLAC. In the high‐risk group, the offspring mortality was 3.7/1000 in TOLAC compared with 0.9/1000 in non‐TOLAC, and the 5‐minute Apgar score < 4 was 3.1/1000 in TOLAC compared with 0.9/1000 in non‐TOLAC. In both risk groups, TOLAC delivery had a higher rate of 5‐minute Apgar score < 7. In the low‐risk group, non‐TOLAC deliveries had a higher rate of neonatal respiratory distress syndrome than TOLAC deliveries. Conclusions We observed higher risk of offspring mortality and lower 5‐minute Apgar score in TOLAC than in non‐TOLAC. Possible causes and preventive measures should be explored.