These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Neonatal outcomes following a trial of labor after Caesarean delivery: a population-based study.
    Author: Litwin CE, Czuzoj-Shulman N, Zakhari A, Abenhaim HA.
    Journal: J Matern Fetal Neonatal Med; 2018 Aug; 31(16):2148-2154. PubMed ID: 28573941.
    Abstract:
    PURPOSE: To evaluate the neonatal effects of trial of labor after Caesarean (TOLAC) births. METHODS: We conducted a retrospective population-based cohort study using the CDC's Period Linked Birth/Infant Death Public Use File (2011-2013) on women with a live singleton pregnancy and prior Caesarean delivery. Multivariate logistic regression compared neonatal outcomes between women who underwent a TOLAC with women who did not. Secondary analysis compared outcomes of birth with uterine rupture to those without. RESULTS: A total of 1,036,554 births met inclusion criteria, of which 17.5% underwent TOLAC. Women who had a TOLAC were more likely to deliver infants requiring neonatal intensive care unit (NICU) admission (odds ratios (OR) 1.12, 95%CI 1.09-1.16) and assisted ventilation (OR 1.07, 95%CI 1.03-1.12). Among women with TOLAC, 0.18% of births were in context of a uterine rupture and those neonates had an increased risk of NICU admissions (OR 5.95, 95%CI 4.56-7.76), assisted ventilation (OR 8.89, 95%CI 6.73-11.75), seizures (OR 91.66, 95%CI 42.23-198.93), and death (OR 16.28, 95%CI 5.09-52.08). CONCLUSIONS: Neonatal morbidity appears slightly increased among women with a TOLAC. However, morbidity and mortality are considerably increased in cases of uterine rupture. Appropriate selection and counseling of women for TOLAC should be undertaken as to minimize uterine rupture risk.
    [Abstract] [Full Text] [Related] [New Search]