Second cesarean safer than VBAC
NEWS IN BRIEF — Posted Jan. 17, 2005
Attempting a vaginal delivery after a cesarean puts the woman at increased risk of uterine rupture or endometritis but has no impact on the rate of maternal death or hysterectomy, according to a paper in the Dec. 16, 2004, New England Journal of Medicine.
Researchers at 19 academic health centers participating in a study funded by the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network prospectively observed more than 30,000 women over four years who had delivered initially by cesarean. More than 15,000 decided to have a cesarean for their subsequent births; more than 17,000 attempted to deliver vaginally. Of these, just under 1% had a uterine rupture. Nearly 3% developed endometritis, while just under 2% of those who had a second cesarean did.
The authors concluded that VBAC is riskier than a second cesarean, though the absolute risks are low.
"While the magnitude of these risks for serious complications is small, women who have had previous cesarean section and who are considering choices for childbirth should be aware of the level of risk involved," said Mark Landon, MD, lead author and vice chair of obstetrics and gynecology at the Ohio State University Medical Center in Columbus.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/01/17/hlbf0117.htm.