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Labor after previous cesarean increases risk of perinatal death.(Brief Article)
2002 JUN 13 - (NewsRx.com & NewsRx.net) -- The risk of perinatal death is increased for babies whose mothers have vaginal deliveries after a previous cesarean birth, compared with those who have a planned repeat cesarean delivery, according to an article in the Journal of the American Medical Association.
Gordon C.S. Smith, MD, PhD, of Cambridge University, Cambridge, England, and colleagues analyzed data on births in Scotland between January 1, 1992 and December 31, 1997 to determine the risk of perinatal death among women with uncomplicated pregnancies who carried their babies to term and who had a trial of labor after a previous cesarean delivery. Trial of labor was defined as any vaginal or emergency (unplanned) cesarean delivery occurring at or beyond 37 weeks of pregnancy in a woman who had previously delivered by cesarean method. Delivery-related perinatal death was defined as intrapartum stillbirth (occurring during the birth process), or neonatal death not related to congenital abnormality.
According to background information cited in the article, trial of labor after previous cesarean delivery is associated with increased risk of uterine rupture. But no reliable data exist on the effect of a trial of labor on the risk of perinatal death in otherwise uncomplicated term pregnancies.
The authors analyzed data on 313,238 births. The mothers included 15,515 women who had trial of labor after a previous cesarean delivery. They were compared with 9014 women who had planned repeat cesarean delivery, 151,549 multiparous women in labor (women who had one or more previous pregnancies resulting in potentially viable offspring) who did not deliver by planned cesarean method, and 137,160 nulliparous women in labor who did not deliver by planned cesarean.
"Among women who had a trial of labor following previous cesarean delivery, the overall rate of delivery-related perinatal death was 12.9 per 10,000 women," the authors report. "This was approximately 11 times greater than the ...
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Source: HighBeam Research, Labor after previous cesarean increases risk of perinatal...