Trial of labor following cesarean among patients with polyhydramnios: a multicenter retrospective study.

Amniotic fluid Maternal outcomes Neonatal outcomes Planned repeat cesarean delivery Polyhydramnios Trial of labor after cesarean Uterine rupture

Journal

Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213

Informations de publication

Date de publication:
21 Sep 2024
Historique:
received: 17 04 2024
accepted: 10 09 2024
medline: 21 9 2024
pubmed: 21 9 2024
entrez: 21 9 2024
Statut: aheadofprint

Résumé

This study aimed to assess maternal and neonatal outcomes in patients with polyhydramnios attempting trial of labor after cesarean (TOLAC) compared to those undergoing planned repeat cesarean delivery (PRCD). A multi-center retrospective cohort study was conducted and included women with term singleton viable pregnancies following a single low-segment transverse cesarean delivery (CD) with a polyhydramnios diagnosis (maximal vertical pocket > 8 cm and/or Amniotic Fluid Index > 24 cm) within 14 days before birth who delivered between the years 2017 and 2021. Maternal and neonatal outcomes were compared between those attempting TOLAC and those opting for PRCD. The primary outcome was composite adverse maternal. Univariate analysis was followed by multivariate analysis to control for potential confounders. Out of 358 included births with a previous CD, 208 (58.1%) attempted TOLAC, while 150 had PRCD (41.9%). The successful vaginal birth after cesarean (VBAC) rate was 82.2%, and no cases of uterine rupture, hysterectomy, or maternal intensive care unit admission occurred in either group. After controlling for potential confounders, no independent association between TOLAC and composite adverse maternal (adjusted odds ratio [aOR] 0.62, 95% confidence interval [CI] 0.32-1.20, p = 0.16) and neonatal (aOR 0.89, 95% CI 0.51-1.53, p = 0.67) adverse outcomes was demonstrated. In patients with a term diagnosed polyhydramnios, TOLAC appears to be a reasonable alternative associated with favorable outcomes. Larger prospective studies are needed to refine management strategies and enhance maternal and neonatal outcomes in this context.

Identifiants

DOI: 10.1007/s00404-024-07742-5 PMID: 39305320
pubmed: 39305320
doi: 10.1007/s00404-024-07742-5
pii: 10.1007/s00404-024-07742-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Ari Weiss (A)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel.

Tzuria Peled (T)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel.

Reut Rotem (R)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel. reutah86@gmail.com.
ORCID: 0000-0002-4063-5911

Hen Y Sela (HY)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel.

Sorina Grisaru-Granovsky (S)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel.

Misgav Rottenstreich (M)

Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, 12 Bayit Street, 91031, Jerusalem, Israel.
Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel.

Classifications MeSH