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• W2001086051 abstract "ObjectiveTo study the effectiveness and safety of induction of labor and elective repeat cesarean section (CS) in women with prior CS and indication for delivery.Study DesignWe performed a prospective cohort study in 53 hospitals in the Netherlands. We included pregnant women in 2nd and 3rd trimester with a singleton pregnancy and previous CS with an indication for delivery. We investigated elective repeat CS (group 1) and trial of labor (TOL). The TOL group contained women with a favorable cervix, induced by oxytocin augmentation (group 2) or amniotomy (group 3), and women with an unfavorable cervix, induced by prostaglandins (group 4) or balloon catheter (group 5). Maternal, neonatal and obstetric variables were collected.ResultsOf the 2411 women included, 27% underwent an elective CS and 73% underwent TOL. Maternal characteristics and delivery outcomes are shown in the table.Vaginal delivery occurred most often in the favorable cervix group. Operative delivery for fetal distress was most often performed in the prostaglandin group. In the TOL group, uterine scar rupture occurred in 0.7%-2.7 %, most often in the prostaglandin group. Postpartum hemorrhage and blood transfusion occurred most often after repeat CS and induction with balloon catheter. Poor neonatal outcomes (Apgar scores <7 at 5 min and umbilical cord pH <7.10) were most often seen in the oxytocin augmentation group. There were no significant differences in maternal or neonatal morbidity when comparing the prostaglandin and the balloon catheter group.ConclusionTabled 1Comparison of elective repeat cesarean section (CS) and methods for induction of labor in women with prior CS and indication for deliveryCS: cesarean section; TOL: trial of labor; BMI: Body Mass Index.∗Non elective reasons are included. ˆMore than 1 liter. △Umbilical cord pH missing values: total 742; per group: 227,18, 161, 13, 323, respectively. §Unpaired t-test. ‡Chi-square test. Open table in a new tab ObjectiveTo study the effectiveness and safety of induction of labor and elective repeat cesarean section (CS) in women with prior CS and indication for delivery. To study the effectiveness and safety of induction of labor and elective repeat cesarean section (CS) in women with prior CS and indication for delivery. Study DesignWe performed a prospective cohort study in 53 hospitals in the Netherlands. We included pregnant women in 2nd and 3rd trimester with a singleton pregnancy and previous CS with an indication for delivery. We investigated elective repeat CS (group 1) and trial of labor (TOL). The TOL group contained women with a favorable cervix, induced by oxytocin augmentation (group 2) or amniotomy (group 3), and women with an unfavorable cervix, induced by prostaglandins (group 4) or balloon catheter (group 5). Maternal, neonatal and obstetric variables were collected. We performed a prospective cohort study in 53 hospitals in the Netherlands. We included pregnant women in 2nd and 3rd trimester with a singleton pregnancy and previous CS with an indication for delivery. We investigated elective repeat CS (group 1) and trial of labor (TOL). The TOL group contained women with a favorable cervix, induced by oxytocin augmentation (group 2) or amniotomy (group 3), and women with an unfavorable cervix, induced by prostaglandins (group 4) or balloon catheter (group 5). Maternal, neonatal and obstetric variables were collected. ResultsOf the 2411 women included, 27% underwent an elective CS and 73% underwent TOL. Maternal characteristics and delivery outcomes are shown in the table.Vaginal delivery occurred most often in the favorable cervix group. Operative delivery for fetal distress was most often performed in the prostaglandin group. In the TOL group, uterine scar rupture occurred in 0.7%-2.7 %, most often in the prostaglandin group. Postpartum hemorrhage and blood transfusion occurred most often after repeat CS and induction with balloon catheter. Poor neonatal outcomes (Apgar scores <7 at 5 min and umbilical cord pH <7.10) were most often seen in the oxytocin augmentation group. There were no significant differences in maternal or neonatal morbidity when comparing the prostaglandin and the balloon catheter group. Of the 2411 women included, 27% underwent an elective CS and 73% underwent TOL. Maternal characteristics and delivery outcomes are shown in the table. Vaginal delivery occurred most often in the favorable cervix group. Operative delivery for fetal distress was most often performed in the prostaglandin group. In the TOL group, uterine scar rupture occurred in 0.7%-2.7 %, most often in the prostaglandin group. Postpartum hemorrhage and blood transfusion occurred most often after repeat CS and induction with balloon catheter. Poor neonatal outcomes (Apgar scores <7 at 5 min and umbilical cord pH <7.10) were most often seen in the oxytocin augmentation group. There were no significant differences in maternal or neonatal morbidity when comparing the prostaglandin and the balloon catheter group. ConclusionTabled 1Comparison of elective repeat cesarean section (CS) and methods for induction of labor in women with prior CS and indication for deliveryCS: cesarean section; TOL: trial of labor; BMI: Body Mass Index.∗Non elective reasons are included. ˆMore than 1 liter. △Umbilical cord pH missing values: total 742; per group: 227,18, 161, 13, 323, respectively. §Unpaired t-test. ‡Chi-square test. Open table in a new tab CS: cesarean section; TOL: trial of labor; BMI: Body Mass Index. ∗Non elective reasons are included. ˆMore than 1 liter. △Umbilical cord pH missing values: total 742; per group: 227,18, 161, 13, 323, respectively. §Unpaired t-test. ‡Chi-square test." @default.
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• W2001086051 date "2014-01-01" @default.
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• W2001086051 title "682: Effectiveness and safety of different methods for induction of labor in women with a previous cesarean section" @default.
• W2001086051 doi "https://doi.org/10.1016/j.ajog.2013.10.715" @default.
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