Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery

Mildred M Ramirez; Sharon Gilbert; Mark B Landon; Dwight J Rouse; Catherine Y Spong; Michael W Varner; Steve N Caritis; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary J O'Sullivan; Baha M Sibai; Oded Langer; John M Thorp; Brian M Mercer

doi:10.1055/s-0030-1254548

American Journal of Perinatology, Table of Contents

Am J Perinatol 2010; 27(10): 825-830
DOI: 10.1055/s-0030-1254548

Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery

Mildred M. Ramirez¹ , Sharon Gilbert² , Mark B. Landon³ , Dwight J. Rouse⁴ , Catherine Y. Spong⁵ , Michael W. Varner⁵ ^, ⁶ , Steve N. Caritis⁵ ^, ⁷ , Ronald J. Wapner⁵ ^, ⁸ , Yoram Sorokin⁵ ^, ⁹ , Menachem Miodovnik⁵ ^, ¹⁰ ^, ¹¹ , Marshall Carpenter⁵ ^, ¹² , Alan M. Peaceman⁵ ^, ¹³ , Mary J. O'Sullivan⁵ ^, ¹⁴ , Baha M. Sibai⁵ ^, ¹⁵ , Oded Langer⁵ ^, ¹⁶ , John M. Thorp⁵ ^, ¹⁷ , Brian M. Mercer⁵ ^, ¹⁸ for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network

¹Departments of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Houston, Texas
²The George Washington University Biostatistics Center, Washington, DC
³The Ohio State University, Columbus, Ohio
⁴University of Alabama at Birmingham, Birmingham, Alabama
⁵University of Utah, Salt Lake City; Utah
⁶the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland
⁷University of Pittsburgh, Pittsburgh, Pennsylvania
⁸Thomas Jefferson University, Philadelphia, Pennsylvania
⁹Wayne State University, Detroit, Michigan
¹⁰University of Cincinnati, Cincinnati, Ohio
¹¹Columbia University, New York, New York
¹²Brown University, Providence, Rhode Island
¹³Northwestern University, Chicago, Illinois
¹⁴University of Miami, Miami, Florida
¹⁵University of Tennessee, Memphis, Tennessee
¹⁶University of Texas Health Science Center at San Antonio, San Antonio, Texas
¹⁷University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
¹⁸Case Western Reserve University, Cleveland, Ohio

Abstract

ABSTRACT

We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD ≥20 weeks' gestation or 500 g were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age ± standard deviation at delivery was 31.3 ± 6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases.

KEYWORDS

Vaginal birth after cesarean - fetal demise - induction of labor

Full Text

References

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Mildred M RamirezM.D.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston

6431 Fannin, Suite 3.276, Houston, TX 77030

Email: Mildred.M.Ramirez@uth.tmc.edu