Cervical ripening with low-dose prostaglandins in planned vaginal birth after cesarean.

Abstract

OBJECTIVES:

To compare uterine rupture, maternal and perinatal morbidity rates in women with one single previous cesarean after spontaneous onset of labor or low-dose prostaglandin-induced cervical ripening for unfavourable cervix.

STUDY DESIGN:

This was a retrospective cohort study of 4,137 women with one single previous cesarean over a 22-year period. Inpatient prostaglandin administration consisted in single daily local applications.

RESULTS:

Vaginal delivery was planned for 3,544 (85.7%) patients, 2,704 (76.3%) of whom delivered vaginally (vaginal birth after Cesarean (VBAC) rate = 65.4%). Among women receiving prostaglandins (n=515), 323 (62.7%) delivered vaginally. Uterine rupture (0.7% compared with 0.8%, OR 1.1, 95% CI 0.4-3.4, p=0.88), maternal (0.9% compared with 1.2%, OR 1.3, 95% CI 0.5-3.2, p=0.63) and perinatal (0.3% compared with 0.8%, OR 2.4, 95% CI 0.7-8.5, p=0.18) morbidity rates did not differ significantly between patients with spontaneous onset of labor and those receiving prostaglandins, nor did these rates differ according to the planned mode of delivery.

CONCLUSION:

In comparison with patients with spontaneous labor, inducing cervical ripening with low-dose prostaglandins in case of unfavourable cervix is not associated with appreciable increase in uterine rupture, maternal or perinatal morbidity.

• Authors: Thomas Schmitz, Anne-Gaelle Pourcelot, Constance Moutafoff, Valérie Biran, Olivier Sibony, Jean-François Oury
• Journal: PloS one (PLoS One) Vol. 8 Issue 11 Pg. e80903 ( 2013) ISSN: 1932-6203 [Electronic] United States
• PMID: 24260505 (Publication Type: Journal Article)

Chemical References

• Oxytocics
• Prostaglandins

Topics

• Adult
• Cervical Ripening (drug effects)
• Cervix Uteri (drug effects)
• Drug Administration Schedule
• Female
• Humans
• Labor, Induced (methods)
• Oxytocics
• Pregnancy
• Prostaglandins
• Retrospective Studies
• Trial of Labor
• Uterine Rupture (prevention & control)
• Vaginal Birth after Cesarean