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  • Vaginal Birth After Two Caesarean Sections (VBAC-2) - A Systematic Review With Meta-Analysis of Success Rate and Adverse Outcomes of VBAC-2 Versus VB..

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    This systematic review analyzed 20 studies on vaginal birth after two cesarean sections (VBAC-2). The review found a VBAC-2 success rate of 71.1% with a uterine rupture rate of 1.36%. VBAC-2 was associated with higher risks of uterine rupture and hysterectomy compared to VBAC-1. However, maternal morbidity outcomes like hysterectomy rates, blood transfusion, and febrile morbidity were comparable between VBAC-2 and repeat cesarean section (RCS). The review concluded that women requesting a trial of vaginal delivery after two cesareans should be appropriately counseled on the success rate of 71.1% and uterine rupture rate of 1.36

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    Abstract of Vaginal Birth After Two Caesarean Sections (VBAC-2) A systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections

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    Vaginal Birth After Two Caesarean Sections (VBAC-2)-A Systematic Review With Meta-Analysis of Success Rate and Adverse Outcomes of VBAC-2 Versus VB..

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    This systematic review analyzed 20 studies on vaginal birth after two cesarean sections (VBAC-2). The review found a VBAC-2 success rate of 71.1% with a uterine rupture rate of 1.36%. VBAC-2 was associated with higher risks of uterine rupture and hysterectomy compared to VBAC-1. However, maternal morbidity outcomes like hysterectomy rates, blood transfusion, and febrile morbidity were comparable between VBAC-2 and repeat cesarean section (RCS). The review concluded that women requesting a trial of vaginal delivery after two cesareans should be appropriately counseled on the success rate of 71.1% and uterine rupture rate of 1.36

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    36 tayangan2 halaman

    Vaginal Birth After Two Caesarean Sections (VBAC-2) - A Systematic Review With Meta-Analysis of Success Rate and Adverse Outcomes of VBAC-2 Versus VB..

    Diunggah oleh

    mila.dia
    This systematic review analyzed 20 studies on vaginal birth after two cesarean sections (VBAC-2). The review found a VBAC-2 success rate of 71.1% with a uterine rupture rate of 1.36%. VBAC-2 was associated with higher risks of uterine rupture and hysterectomy compared to VBAC-1. However, maternal morbidity outcomes like hysterectomy rates, blood transfusion, and febrile morbidity were comparable between VBAC-2 and repeat cesarean section (RCS). The review concluded that women requesting a trial of vaginal delivery after two cesareans should be appropriately counseled on the success rate of 71.1% and uterine rupture rate of 1.36

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    Abstract Fulltextlinks

    BJOG.2010Jan117(1):519.doi:10.1111/j.14710528.2009.02351.x.

    Vaginalbirthaftertwocaesareansections(VBAC2)asystematicreview
    withmetaanalysisofsuccessrateandadverseoutcomesofVBAC2
    versusVBAC1andrepeat(third)caesareansections.
    TahseenS1,GriffithsM.

    Authorinformation

    Abstract
    BACKGROUND: TrialofvaginalbirthafterCaesarean(VBAC)isconsideredacceptableafterone
    caesareansection(CS),however,womenwishingtohavetrialaftertwoCSaregenerallynot
    allowedorcounselledappropriatelyofefficacyandcomplications.
    OBJECTIVE: Toperformasystematicreviewofliteratureonsuccessrateofvaginalbirthaftertwo
    caesareansections(VBAC2)andassociatedadversematernalandfetaloutcomesandcompare
    withcommonlyacceptedVBAC1andthealternativeoptionofrepeatthirdCS(RCS).
    SEARCHSTRATEGY: WesearchedMEDLINE,EMBASE,CINAHL,CochraneLibrary,Current
    ControlledTrials,HMICDatabase,GreyLiteratureDatabases(SIGLE,BiomedCentral),using
    searchtermsCaesareansection,caesarian,C*rean,C*rian,andMeSHheadings'Vaginalbirthafter
    caesareansection',combinedwithsecondsearchstringtwo,twice,second,multiple.
    SELECTIONCRITERIA: Norandomisedstudieswereavailable,caseseriesorcohortstudieswere
    assessedforquality(STROBE),20/23availablestudiesincluded.
    DATACOLLECTIONANDANALYSIS: Twoindependentreviewersselectedstudiesand
    abstractedandtabulateddataandpooledestimateswereobtainedonsuccessrate,uterinerupture
    andotheradversematernalandfetaloutcomes.MetaanalyseswereperformedusingRevMan5to
    compareVBAC1versusVBAC2andVBAC2versusRCS.
    MAINRESULTS: VBAC2successratewas71.1%,uterinerupturerate1.36%,hysterectomyrate
    0.55%,bloodtransfusion2.01%,neonatalunitadmissionrate7.78%andperinatalasphyxial
    injury/death0.09%.VBAC2versusVBAC1successrateswere4064/5666(71.1%)versus38
    814/50685(76.5%)(P<0.001)associateduterinerupturerate1.59%versus0.72%(P<0.001)
    andhysterectomyrateswere0.56%versus0.19%(P=0.001)respectively.ComparingVBAC2
    versusRCS,thehysterectomyrateswere0.40%versus0.63%(P=0.63),transfusion1.68%
    versus1.67%(P=0.86)andfebrilemorbidity6.03%versus6.39%,respectively(P=0.27).Maternal
    morbidityofVBAC2wascomparabletoRCS.Neonatalmorbiditydataweretoolimitedtodrawvalid
    conclusions,however,nosignificantdifferenceswereindicatedinVBAC2,VBAC1andRCS
    groupsinNNUadmissionratesandasphyxialinjury/neonataldeathrates(MantelHaenszel).
    CONCLUSIONS: Womenrequestingforatrialofvaginaldeliveryaftertwocaesareansections
    shouldbecounselledappropriatelyconsideringavailabledataofsuccessrate71.1%,uterine
    rupturerate1.36%andofacomparativematernalmorbiditywithrepeatCSoption.

    Commentin
    Canvaginalbirthaftercaesareanbejustified? [BJOG.2010]

    PMID:19781046[PubMedindexedforMEDLINE]

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