Vaginal birth after c-section safe after due date
|
|
Women who have undergone a prior cesarean delivery can safely attempt to give birth vaginally in a subsequent pregnancy, even when they’re at or beyond 40 weeks, US researchers report. However, the chances of being able to complete a vaginal birth are reduced.
The safety of vaginal birth after cesarean (VBAC) in a variety of situations has been investigated before, the team explains in the journal Obstetrics & Gynecology, but little has been published about VBAC attempts for women at or past their expected delivery date.
Dr. Kara M. Coassolo from the Hospital of the University of Pennsylvania, Philadelphia, and colleagues looked at outcomes for 11,587 women attempting VBAC before and after 40 weeks of gestation.
Women at or after their estimated date of delivery were less likely to be successful (69 percent) than were women before their estimated date of delivery (78 percent), the authors report.
Doctors “can counsel women that the chances of VBAC success are decreased in gestations that continue beyond the estimated delivery date compared with those before 40 weeks,” the team concludes. “However, patients can be reassured that the success rate of almost 70 percent is still quite good.”
Rates of operative complications and adverse effects for the mother were also higher for women who attempted VBAC at or beyond 40 weeks of gestation, the report indicates, but the difference disappeared once other risk factors were accounted for.
Still, the researchers note, women attempting VBAC fared somewhat worse overall than those opting for repeat cesarean delivery.
However, “the absolute risk is small,” the team notes. For example, “In women past 40 weeks of gestation, the risk of uterine rupture is 1.1 percent in women attempting VBAC compared with 0.08 percent in those electing repeat cesarean delivery.”
Thus, the researchers write, “The risks of a VBAC attempt are not increased simply because the due date has passed.”
SOURCE: Obstetrics & Gynecology, October 2005.
Print Version
Tell-a-Friend comments powered by Disqus
