25/12/2022
‘A history of multiple cesarean births is not associated with an increased rate of uterine rupture in women attempting vaginal birth compared with those with a single prior caesarean’, from the 2006 research article by Landon et al called ‘risk of uterine rupture with a trial of Labor in women with multiple and single prior caesarean delivery’.
Landon found that uterine rupture occurred for 9 out of 975 (0.9%) women who had multiple previous cesareans and 115 out of 16 915 (0.7%) women who had one prior cesarean birth. So whether you’ve experienced one or more prior births by cesarean, your chances of uterine rupture while attempting a VBAC is less than 1%.
Landon et al concluded that ‘maternal morbidity is increased with trial of labour after multiple cesareans, compared with elective repeat cesareans, but the absolute risk for complications is small’.
Landon et al were also able to report the success rates of VBAC in a hospital setting and found that women with a single prior cesarean had a success rate of 74%, 67% success rate if they had two prior cesareans, 63% for three prior and 55% for four prior cesarean births.
Risk factors for uterine rupture identified in this study were oxytocin augmentation, induction of labour, epidural and less than a 2 year interval from previous cesarean. Both prior vaginal birth and prior successful VBAC were associated with lower risk for this complication...
Landon et al conclude by stating, ‘vaginal birth after multiple cesarean deliveries (births) should remain an option for eligible women’.
