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Int J Obes (Lond) 2019 Feb 14. Epub 2019 Feb 14.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Background: Mother-to-newborn transmission of obesity-associated microbiota may be modified by birth mode (vaginal vs. Cesarean delivery). Prospective data to test this hypothesis are still sparse. Read More

Am J Obstet Gynecol 2019 Feb 11. Epub 2019 Feb 11.

Department of Gynaecology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.

Background: By being non-invasive, medical termination of pregnancy has increased worldwide access to abortion and improved safety of unsafe abortion. However, secondary surgical intervention is the most frequent complication to medical abortion.

Objective: We aimed to identify and quantify risk factors for surgical intervention in women undergoing medically induced termination of pregnancy before nine completed weeks of gestation. Read More

Acta Obstet Gynecol Scand 2019 Feb 14. Epub 2019 Feb 14.

Norwegian National Advisory Unit on Women's Health, Rikshospitalet Oslo University Hospital, Oslo, Norway.

Introduction: Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large data sets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. Read More

Reprod Health 2019 Feb 8;16(1):15. Epub 2019 Feb 8.

Maternal Health Department, Ministry of Health, Tehran, Iran.

Background: Iran has one of the highest national caesarean section rates worldwide. Few studies explored in-depth the health-facility and health-system level factors that affect women's choices on mode of delivery in Iran. The aim of this study was to explore the health-facility and health-system level factors affecting women's preferences on mode of delivery in Tehran. Read More

Acta Obstet Gynecol Scand 2019 Feb 5. Epub 2019 Feb 5.

Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France, DHU Risks in Pregnancy, Paris, France; Sorbonne Medical Faculty Paris Descartes UniversityParis, France.

Introduction: Whilst spontaneous onset of labor and vaginal delivery for breech presentation is considered to be a safe and effective option in selected cases, the safety of induction of labor is not established yet. The objectives of this study were to describe the outcomes of pregnancy in women induced with a fetus in breech presentation and compare with those undergoing planned caesarean delivery.

Material And Methods: We performed a secondary analysis of the observational prospective multicenter PREMODA study, including all singleton breech deliveries after 37 weeks in 174 centers in France and Belgium. Read More

Acta Obstet Gynecol Scand 2019 Feb 5. Epub 2019 Feb 5.

University Medical Center Utrecht, Division Women and Baby, Department of Obstetrics, Birth Center Wilhelmina Children's Hospital, Utrecht, the Netherlands.

Introduction: When women with a previous cesarean section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or perform a cesarean section. This study aims to assess the effectiveness and safety of a balloon catheter as method of induction of labor in women with one previous cesarean section and an unfavorable cervix compared to an elective repeat cesarean section.

Material And Methods: We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous cesarean section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. Read More

Am J Obstet Gynecol 2019 Feb 1. Epub 2019 Feb 1.

Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina.

Background: The use of trial of labor after Cesarean (TOLAC) calculators in the prediction of successful vaginal birth after Cesarean (VBAC) gives physicians an evidence-based tool to assist with patient counseling and risk stratification. Prior to deploying prediction models for routine care at an institutional level, it is recommended to initially test their performance in the institution's target population. This allows the institution to understand not only the overall accuracy of the model for the intended population but also to comprehend where the accuracy of the model is most limited when predicting across the range of predictions (calibration). Read More

Pediatr Neonatol 2019 Jan 19. Epub 2019 Jan 19.

Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. Electronic address:

Background: Although the mode of delivery is well known to affect pulmonary function, the effects of a cesarean delivery on postnatal changes in cardiac mechanics have not been clearly defined.

Methods: To evaluate whether delivery mode influences cardiac function in the early transitional period, 42 infants delivered by cesarean section (CS) and 110 by vaginal delivery (VD) were enrolled, and they underwent serial echocardiography at 0, 1, 2, and 5 days of age. Longitudinal changes in ejection fraction (EF), fractional area change (FAC), mitral annular plane systolic excursion (MAPSE), tricuspid annular plane systolic excursion (TAPSE), Tei index, ratio of peak early diastolic flow velocity (E) to peak early diastolic annular velocity (e') (E/e'), and deceleration time (DcT) were compared between the two groups. Read More

J Matern Fetal Neonatal Med 2019 Jan 30:1-8. Epub 2019 Jan 30.

b Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine , Thomas Jefferson University Hospital , Philadelphia , Pennsylvania , USA.

Background: Membrane sweeping has been shown to reduce time to the onset of labor in women at term but the effects of membrane sweeping in women with a prior cesarean delivery are largely unknown.

Objective: To determine the effects of membrane sweeping on promoting labor in patients undergoing a trial of labor after cesarean.

Study Design: Searches were performed in Medline, Ovid, Scopus, ClinicalTrials. Read More

Acta Obstet Gynecol Scand 2019 Jan 30. Epub 2019 Jan 30.

Department of Gynecology and Obstetrics, Holbaek Hospital, Holbaek, Denmark.

Introduction: To compare short-term maternal outcomes in healthy primiparous women with uncomplicated pregnancies who delivered a singleton child in term by planned cesarean or planned vaginal delivery.

Material And Methods: Nationwide population-based cohort study of 145 821 low-risk primiparous women with healthy singletons in cephalic position in Denmark, 2008-2016. Data from the Medical Birth Register and the Danish National Patient Registry were linked and compared according to planned mode of delivery. Read More

Obstet Gynecol 2019 Feb;133(2):e110-e127

Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to deliver vaginally by a woman who has had a previous cesarean delivery, regardless of the outcome. This method provides women who desire a vaginal delivery the possibility of achieving that goal-a vaginal birth after cesarean delivery (VBAC). In addition to fulfilling a patient's preference for vaginal delivery, at an individual level, VBAC is associated with decreased maternal morbidity and a decreased risk of complications in future pregnancies as well as a decrease in the overall cesarean delivery rate at the population level (). Read More

Obstet Gynecol 2019 Feb;133(2):393-395

Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to deliver vaginally by a woman who has had a previous cesarean delivery, regardless of the outcome. This method provides women who desire a vaginal delivery the possibility of achieving that goal-a vaginal birth after cesarean delivery (VBAC). In addition to fulfilling a patient's preference for vaginal delivery, at an individual level, VBAC is associated with decreased maternal morbidity and a decreased risk of complications in future pregnancies as well as a decrease in the overall cesarean delivery rate at the population level (1-3). Read More

J Matern Fetal Neonatal Med 2019 Feb 10:1-8. Epub 2019 Feb 10.

b Department of Gynecology and Obstetrics, Uniwersytet Warminsko-Mazurski Wydzial Nauk Medycznych , Olsztyn , Poland.

Background: There is a great number of studies dealing with the impact of birth anesthesia on the course of labor and condition of the newborn. The aim of this study was to investigate the impact of birth anesthesia on the parameters of oxygenation and acid-base balance in umbilical cord blood.

Methods: Subjects were divided into four groups: vaginal delivery without anesthesia, vaginal delivery with epidural anesthesia, delivery by cesarean section under a subarachnoid block, and delivery by cesarean section under general anesthesia. Read More

J Obstet Gynecol Neonatal Nurs 2019 Jan 18. Epub 2019 Jan 18.

Objective: To examine whether delayed newborn bathing would increase rates of in-hospital exclusive breastfeeding and plans to use human milk at discharge.

Design: A retrospective, two-group, pre- and postintervention design.

Setting/local Problem: At our facility, the initial bath was completed within 2 hours of birth, and the rate of in-hospital exclusive breastfeeding was low. Read More

J Perinat Neonatal Nurs 2019 Jan/Mar;33(1):52-60

Nursing Practice and Education, University of Minnesota Medical Center, Minneapolis (Ms Gams); University of Minnesota Masonic Children's Hospital, Minneapolis (Ms Gams); University of Minnesota School of Nursing, Minneapolis (Dr Neerland); University of Minnesota Health, Women's Health Specialists Clinic, Minneapolis (Dr Neerland); and Southside Community Health Clinic, Minneapolis, Minnesota (Dr Kennedy).

Primary cesarean birth increases a woman's risk for hemorrhage, infection, pain, and cesarean births with subsequent pregnancies. A woman may experience difficulties with breastfeeding, bonding, and incorporating the newborn into the family structure. One urban, academic hospital in the Midwest participated in the American College of Nurse-Midwives Healthy Birth Initiative: Reducing Primary Cesarean Births Project. Read More

Obstet Gynecol Sci 2019 Jan 27;62(1):11-18. Epub 2018 Nov 27.

Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Seoul, Korea.

Objective: In this study, we evaluated the prevalence of allergic disease in offsprings delivered via the delivery modes of vaginal delivery vs. planned Cesarean section vs. Cesarean section with labor. Read More

J Matern Fetal Neonatal Med 2019 Jan 17:1-7. Epub 2019 Jan 17.

a Department of Obstetrics and Gynecology, Sheba Medical Center , Tel-Hashomer, Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel.

Introduction: The aim of this study was to assess the success rate of a trial of labor after a previous cesarean section (TOLAC) in the settings of premature rupture of membranes (PROM) and to compare conservative management with spontaneous labor and induction of labor.

Methods: This was a retrospective cohort study conducted in a single tertiary care center between January 2011 and March 2017. Women with singleton pregnancy and a previous cesarean section (CS) who presented with PROM and underwent TOLAC were included. Read More

J Matern Fetal Neonatal Med 2019 Jan 31:1-7. Epub 2019 Jan 31.

a MOE, Shanghai Key Laboratory of Children's Environmental Health , Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.

Aim: This study investigated whether the parturition mode (vaginal or cesarean [C-] section) affects breast milk concentrations of four essential trace elements (iron, copper, zinc, and manganese).

Methods: Women giving birth at seven hospitals in seven different regions of China were enrolled in the study. Each participant provided breast milk, collected on postpartum day 3-5, for determination of iron, copper, zinc, and manganese concentrations. Read More

JAMA Netw Open 2018 Nov 2;1(7):e185025. Epub 2018 Nov 2.

Duke-NUS Medical School, Singapore, Singapore.

Importance: Global cesarean delivery (CD) rates have more than doubled over the past 2 decades, with an increasing contribution from elective CDs. Cesarean delivery has been linked to early childhood overweight and obesity, but limited studies have examined elective and emergency CDs separately.

Objective: To investigate whether elective or emergency CD was associated with risk of early childhood overweight. Read More

Neurourol Urodyn 2019 Jan 15. Epub 2019 Jan 15.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P. R. China.

Objective: To investigate the extent of lower urinary tract symptoms (LUTS) during pregnancy and 7 years after birth in primipara and their association with delivery mode history and other factors.

Methods: A longitudinal cohort study was conducted in 12 hospitals representative of the diversity of the seven administrative regions of China. Of 10 098 women recruited at the third trimester, 3862 (38. Read More

Pan Afr Med J 2018 6;30:255. Epub 2018 Aug 6.

Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun.

The rate of uterine scars, an established risk factor for obstetric morbidity, is increasing worldwide. In developing countries, spontaneous uterine ruptures may constitute 87.4% of cases. Read More

Am J Obstet Gynecol 2019 Jan 8. Epub 2019 Jan 8.

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 50603, Malaysia.

Background: Labor is induced in 20-30% of maternities with an increasing trend of use. Labor induction with oral misoprostol is associated with reduced risk of Cesarean births and has a comparable safety and effectiveness profile to mechanical method like with the Foley catheter. Labor induction in nulliparous women continues to be challenging with the process often quite protracted and eventual Cesarean rate is high and particularly so when the cervix is unfavorable and ripening is required. Read More

J Family Med Prim Care 2018 Nov-Dec;7(6):1542-1547

Department of Obstetrics and Gynecology, Marat Ospanov, West Kazakhstan State Medical University (WKSMU), Aktobe, Kazakhstan.

Background: Vaginal birth after cesarean section (VBAC) increases the chance of subsequent vaginal deliveries and reduces the repeat cesarean section (CS) rate with subsequent postoperative morbidity.

Objectives: To detect the outcome of VBAC during the second birth order in Aktobe region of West Kazakhstan.

Patients And Methods: A total of 832 women eligible for trial of VBAC were included in this study. Read More

JAMA 2018 12;320(23):2438-2447

Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland.

Importance: Pelvic floor disorders (eg, urinary incontinence), which affect approximately 25% of women in the United States, are associated with childbirth. However, little is known about the course and progression of pelvic floor disorders over time.

Objective: To describe the incidence of pelvic floor disorders after childbirth and identify maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery. Read More

Clin Transl Sci 2019 Jan 18;12(1):53-57. Epub 2018 Dec 18.

The Second Department of Obstetrics, Cangzhou Central Hospital, Cangzhou, Yunhe District, Hebei Province, China.

This study was designed to establish a modified prediction score system to improve the safety and success rate of vaginal birth after cesarean delivery (VBAC). We recruited 406 patients (between January 2012 and December 2016) and generated a modified score system in predicting the success rate of VBAC. All patients were required to sign informed consent forms. Read More

J Matern Fetal Neonatal Med 2018 Dec 6:1-161. Epub 2018 Dec 6.

a Department of Obstetrics and Gynecology , Maimonides Medical Center , Brooklyn, New York , New York , USA.

Objective: To evaluate the association of pregestational diabetes with uterine rupture during a trial of labor with one prior cesarean delivery.

Study Design: A retrospective study of women undergoing trial of labor after cesarean. The study group consisted of women with pregestational diabetes, and control group was women without pregestational diabetes. Read More

Am J Perinatol 2018 Nov 30. Epub 2018 Nov 30.

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California.

Objective:  Excessive gestational weight gain (GWG) has been associated with adverse pregnancy outcomes, including increased risk of cesarean delivery (CD). Data are limited on associations between GWG and outcomes in women undergoing trial of labor after cesarean (TOLAC). We aimed to investigate whether appropriate GWG impacts TOLAC outcomes. Read More

Midwifery 2019 Feb 22;69:121-127. Epub 2018 Nov 22.

Department of Obstetrics and Gynaecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Denmark; Department of Clinical Medicine, Aarhus University, Incuba / Skejby Building 2 Palle Juul-Jensens Boulevard 82, Aarhus DK-8200, Denmark. Electronic address:

Introduction: Diabetes Mellitus in pregnancy is increasing. No existing studies have examined Diabetes Mellitus as the primary exposure for lower genital tract tears after vaginal birth. The objective was to study the association between Diabetes Mellitus (all types combined), Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus and lower genital tract tears after vaginal birth. Read More

J Matern Fetal Neonatal Med 2018 Nov 28:1-181. Epub 2018 Nov 28.

b Department of Obstetrics and Gynecology , Brigham and Women's Hospital , Harvard Medical School , Boston , USA.

Objective: The purpose of this study is to assess the incidence of oligohydramnios at term and evaluate whether mode of delivery in patients with oligohydramnios influences perinatal outcomes in China.

Methods: A cross sectional survey of all deliveries in 39 hospitals in China from 1 January to 31 December, 2011 was evaluated for mode of delivery and perinatal outcomes in women with oligohydramnios compared to those without known oligohydramnios after excluding preterm births, polyhydramnios, and oligohydramnios secondary to premature rupture of membranes.

Results: Oligohydramnios complicated 3954 (4. Read More

Ultrasound Obstet Gynecol 2018 Nov 28. Epub 2018 Nov 28.

Department of Obstetrics and Gynecology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.

Objective: To study the effect of cesarean hysterotomy level on the occurrence of large uterine scar defects 6-9 months after delivery.

Methods: This was a two-center, randomized, single-blind trial of a surgical procedure with masked assessment of the principal outcome under study. Women in active labor (cervix dilatation ≥5 cm) were randomized into a high incision (HIGH) or a low incision (LOW) group. Read More

Arch Gynecol Obstet 2018 Nov 22. Epub 2018 Nov 22.

Department of Women's Health, University Hospital of Tuebingen, Tuebingen, Germany.

Purpose: It was the aim to evaluate the personal preference of mode of delivery and to analyze differences between medical professionals and non-medical professionals. Interest in participating in a risk stratification system was evaluated. We hypothesized that gaining information about risk stratification provided in the survey could potentially change participants' decision regarding the preferred mode of delivery; therefore, subjects were asked twice (before and after providing information). Read More

Am J Obstet Gynecol 2018 Nov 19. Epub 2018 Nov 19.

The Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel.

Background: Trial of labor after cesarean is offered as a routine option for singleton gestations with previous cesarean delivery. However, adequate data are not available to determine whether the approach is equally valid in women with twin gestation.

Objective: This systematic review and meta-analysis aimed to assess maternal morbidities associated with trial of labor after cesarean delivery in twin gestations. Read More

BMC Pregnancy Childbirth 2018 Nov 21;18(1):452. Epub 2018 Nov 21.

Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, 1403 - 29 Street NW, Calgary, AB, T2N 2T9, Canada.

Background: Rates of cesarean deliveries have been increasing, and contributes to the rising number of elective cesarean deliveries in subsequent pregnancies with associated maternal and neonatal risks. Multiple guidelines recommend that women be offered a trial of labor after a cesarean (TOLAC). The objective of the study is to systematically review the literature on adjunct clinical interventions that influence vaginal birth after cesarean (VBAC) rates. Read More

Zhonghua Fu Chan Ke Za Zhi 2018 Nov;53(11):768-775

Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

To investigate the clinical features, diagnosis and treatments of heterotopic pregnancy (HP) and demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. A retrospective analysis was performed on 144 cases of HP in Womens Hospital, School of Medicine, Zhejiang University from January 2003 to December 2016. (1) Clinical features of HP:the average age of patients was (30. Read More

J Ultrason 2018 ;18(73):162-165

3rd Department of Gynecology, Medical University of Lublin, Lublin, Poland.

Cesarean sections account for approximately 20% of all deliveries worldwide. In Poland, the percentage of women delivering by cesarean section amounts to over 43%. According to studies, the prevalence of cesarean scar defects ranges from 24-70%. Read More

Acta Obstet Gynecol Scand 2018 Nov 15. Epub 2018 Nov 15.

Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.

Introduction: There is a lack of evidence around the risk of transfusion following vaginal birth after cesarean (VBAC) compared with elective repeat cesarean section (ERCS); this is important for decision-making about birth options. The aim of this study was to determine transfusion rates and risk of transfusion following intended VBAC and ERCS.

Material And Methods: Women with a primary cesarean who had a subsequent birth at term (≥37 weeks) in New South Wales between 2000 and 2012, were identified from the New South Wales Perinatal Data Collection. Read More

Birth 2018 Nov 9. Epub 2018 Nov 9.

School of Nursing, Vanderbilt University, Nashville, Tennessee.

Background: Sixty percent of United States births are to multiparous women. Hospital-level policies and culture may influence intrapartum care and birth outcomes for this large population, yet have been poorly explored using a large, diverse sample. We sought to use national United States data to analyze the association between midwifery presence in maternity care teams and the birth processes and outcomes of low-risk parous women. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Dec 22;231:210-213. Epub 2018 Oct 22.

Oxford Fetal Medicine Unit, Level 6, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom. Electronic address:

Objective: External cephalic version is commonly not performed in women with a previous cesarean section. Fear of uterine rupture and cesarean section in labor are prominent. The risks, however, of these are unclear. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13092

Rationale: Fibroids are common, hormone-dependent, benign uterine tumors. It is estimated that they occur in 20% to 40% of women during their reproductive years. The prevalence of fibroids among pregnant women is 10. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Dec 3;231:198-203. Epub 2018 Oct 3.

University of Milano Bicocca, Milan, Italy; Department of Obstetrics and Gynecology, Carate Brianza Hospital, ASST Vimercate, Italy.

Objective: The aim of this retrospective cohort study was to evaluate the obstetrical and perinatal outcomes of vaginal birth in case of pregnancies achieved after prior myomectomy. We also analyzed how operative characteristics at the time of surgery might influence the choice of obstetricians about mode of delivery.

Study Design: We analyzed retrospectively all women who underwent laparoscopic (LPS) or laparotomic (LPT) myomectomy between January 2002 and December 2014, in a network of three Institutions belonging to the University of Milano Bicocca, Italy. Read More

Gynecol Obstet Fertil Senol 2018 12 30;46(12):1068-1075. Epub 2018 Oct 30.

Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489 - environnement périnatal et croissance, université de Lille, 1, place de Verdun, 59000 Lille, France. Electronic address:

Objective: To identify the ideal gestational age at delivery for preterm premature rupture of membranes and modalities of birth.

Method: To identify studies, research was conducted using Pub-Med, Embase and Cochrane databases.

Results: Prolonged latency duration after pPROM does not worsen neonatal prognosis (NP3). Read More

PLoS One 2018 2;13(11):e0205962. Epub 2018 Nov 2.

Laboratory of Translational Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Porto Alegre-RS, Brazil.

The associations of Cesarean delivery with offspring metabolic and immune-mediated diseases are believed to derive from lack of mother-to-newborn transmission of specific microbes at birth. Bifidobacterium spp., in particular, has been hypothesized to play a health-promoting role, yet little is known about how delivery mode modifies colonization of the newborn by this group of microbes. Read More

Arch Gynecol Obstet 2019 Jan 1;299(1):129-134. Epub 2018 Nov 1.

Meir Medical Center, Sackler School of Medicine, Tel Aviv University, 59 Tchernichovsky St., 4428164, Kfar Saba, Israel.

Purpose: Normal labor curves have not been assessed for women undergoing a trial of labor after cesarean delivery (TOLAC). This study examined labor patterns during TOLAC in relation to epidural analgesia use.

Methods: Retrospective cohort study of deliveries of women undergoing TOLAC at a single, academic, tertiary medical center. Read More

PLoS One 2018 31;13(10):e0205735. Epub 2018 Oct 31.

MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Objective: To describe labor progression patterns with oxytocin for augmentation in women who achieve vaginal delivery; and to determine how long one should wait with effective uterine contraction before labor arrest can be diagnosed.

Design: Population-based retrospective cohort study.

Population: The final sample involved 8,988 women with singleton gestation, term live birth, vertex presentation, no previous cesarean section, vaginal delivery, and neonatal Apgar score at 5 minutes at 7 or higher, and complete information on oxytocin augmentation in 2005-2007. Read More

BMC Pregnancy Childbirth 2018 Oct 29;18(1):427. Epub 2018 Oct 29.

Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

Background: There has been little evaluation of the postpartum quality of life (QOL) of women in India and its association with the mode of birth. This study piloted the use of the generic EQ-5D-5L questionnaire to assess postpartum QOL experienced by rural Indian women.

Methods: A convenience sample of rural women who gave birth in a health facility in Gujarat or Madhya Pradesh was recruited into this pilot study. Read More

J Pediatr Adolesc Gynecol 2019 Feb 24;32(1):7-14. Epub 2018 Oct 24.

Nationwide Children's Hospital, Columbus, Ohio.

Patients born with complex anorectal malformations often have associated Müllerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Read More

Birth 2018 Oct 22. Epub 2018 Oct 22.

Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.

Background: To examine risk of severe perineal trauma among nulliparous women and those undergoing vaginal birth after cesarean delivery (VBAC).

Methods: This is a population-based cohort study of all births to women with their two first consecutive singleton pregnancies in Stockholm-Gotland Sweden between 2008 and 2014. Risk of severe perineal trauma was compared between nulliparous women and those undergoing VBAC with severe perineal trauma being the main outcome measure. Read More

Cochrane Database Syst Rev 2018 10 22;10:CD007462. Epub 2018 Oct 22.

Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, DR.Sardjito Hospital, Jl. Kesehatan No.1, Sekip, Yogyakarta, Daerah Istimewa Yogyakarta, Indonesia, 55281.

Background: The risk of maternal mortality and morbidity (particularly postoperative infection) is higher for caesarean section (CS) than for vaginal birth. With the increasing rate of CS, it is important to minimise the risks to the mother as much as possible. This review focused on different forms and methods of preoperative skin preparation to prevent infection. Read More

BMC Pregnancy Childbirth 2018 Oct 19;18(1):407. Epub 2018 Oct 19.

Department of Gynecology, Xinhua Hospital affiliated with Shanghai Jiaotong University, 1665 Kong Jiang Rd, Yang Pu District, Shanghai, 200092, China.

Background: Although vaginal repair has been conducted to manage caesarean scar diverticula, most studies evaluated only the gynaecological outcomes post-surgery, and their obstetrical outcomes were unknown. This study aimed to evaluate the obstetrical outcomes in vaginal repair-treated caesarean scar diverticula patients.

Methods: A series of 51 symptomatic women with caesarean scar defects or a thickness of the remaining muscular layer of less than 3 mm according to transvaginal ultrasound were included. Read More

J Midwifery Womens Health 2019 Jan 18;64(1):78-87. Epub 2018 Oct 18.

Introduction: Decision aids are central to shared decision making and are recommended for value-sensitive pregnancy decisions, such as birth after cesarean. However, effective strategies for widespread decision aid implementation, with interactive web-based platforms, are lacking. This study tested the feasibility and acceptability of implementing a Health Insurance Portability and Accountability Act-secure, web-based decision aid to support shared decision making about birth choices after cesarean, within urban, ethnically diverse outpatient settings. Read More