The Safety of Maternal and Perinatal of Trial of Labor after Previous Cesarean Delivery Versus Elective Repeat Cesarean Delivery:A Meta-Analysis
CHEN Hong-xiao
TIAN Xiu-fang
Abstract：Objective:The aim of this study was to compare the trial of labor with elective repeat cesarean delivery (ERCD) among women with previous cesarean delivery. Methods:We searched CENTRAL, Medline, Embase, Ovid, Wanfang, CNKI databases about the safety of maternal and perinatal of trial of labor after previous cesarean delivery (TOLAC) versus ERCD from 1989 through 2016. Results:Eleven studies with a total of 91975 women were included. 51428 women undergoing TOLAC, 40547 women undergoing ERCD. Uterine rupture occurred more frequently among women undergoing TOLAC than among those undergoing ERCD (RR=2.78, 95%CI:1.24~6.22, P=0.01). Mothers undergoing TOLAC were less likely to have hysterectomy (RR=0.57,95%CI:0.44~0.74,P<0.0001). There were no differences in maternal puerperal infection (RR=1.10, 95%CI:0.78~1.56, P=0.58), require transfusion (RR=1.09, 95%CI:0.62~1.92, P=0.75) and maternal mortality (RR=0.71, 95%CI:0.26~1.92,P=0.50) risk between the 2 groups. Asphyxia of newborn (RR=2.30,95%CI:1.74~3.03,P<0.00001) and fetal or neonatal death (RR=1.71,95%CI:1.29~2.25,P=0.0001) were more frequent in the TOLAC group than the control group. Conclusions:In order to reduce the rate of cesarean section, we should encourage TOLAC. Its security is very important, which required adequate prenatal assessment, strict and standardized monitoring of the delivery process for the maximum guarantee of maternal and child safety, but also a reasonable and scientific assessment of each cesarean section indications is necessary.
Keywords：Vaginal birth after cesareanNatural childbirthCesarean sectionPostoperative periodUterusCicatrixUterine ruptureMeta-analysis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 430-435 )