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- Title
Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery.
- Authors
Yue-Zhou Yang; Xu-Ping Ye; Xiao-Xi Sun; Yang, Yue-Zhou; Ye, Xu-Ping; Sun, Xiao-Xi
- Abstract
<bold>Purpose: </bold>The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD).<bold>Source: </bold>Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth. Randomized controlled trials (RCTs), two-arm prospective studies, one-arm studies and retrospective studies were included. The primary outcome was uterine rupture.<bold>Principal Findings: </bold>Sixteen studies were included in the meta-analysis. TOL after prior Cesarean delivery was associated with higher odds of uterine rupture as compared with ERCD (Peto odds ratio [OR] = 4.685, 95% confidence interval [CI]: 3.077 to 7.133, p < 0.001). TOL was associated with a higher rate of endometritis, a lower rate of hysterectomy, and a lower rate of respiratory problems in newborns. There were no differences between the groups with respect to neonatal intensive care unit admissions, postpartum hemorrhage, thromboembolic disease, sepsis and neonatal mortality.<bold>Conclusions: </bold>TOL may be associated with a higher risk of uterine rupture and endometritis, but lower risk of hysterectomy and neonatal respiratory problems than ERCD.
- Subjects
NEONATAL diseases; MATERNAL mortality; CESAREAN section; UTERINE rupture; LABOR (Obstetrics); META-analysis; INFANT mortality; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; SYSTEMATIC reviews
- Publication
Clinical & Investigative Medicine, 2017, Vol 40, Issue 3, pE135
- ISSN
0147-958X
- Publication type
journal article
- DOI
10.25011/cim.v40i3.28393