ArticlePloS one2013
At what price? A cost-effectiveness analysis comparing trial of labour after previous caesarean versus elective repeat caesarean delivery.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Providers' perspective on vaginal birth after cesarean birth: a qualitative systematic review.BMC pregnancy and childbirth · 2024Pooled it
- Economic Evaluations Comparing a Trial of Labor with an Elective Repeat Cesarean Delivery: A Systematic Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2017Pooled it
- Success rates of trial of labor after cesarean delivery: the impact of prior vaginal deliveries on outcomes.Archives of gynecology and obstetrics · 2026Article
- Caesarean section and operative vaginal delivery in Estonia and Finland from 1992 to 2016: registry-based study.European journal of public health · 2024Article
- Cost-effectiveness analysis of spontaneous vaginal delivery vs elective cesarean delivery for maternal outcomes in Colombia.AJOG global reports · 2023Article
- Cost Analysis of Intranatal Care Services at a Tertiary Care Public Sector Hospital in Rajasthan, India.Cureus · 2023Article
- Safety Warning about Laparoscopic Power Morcellation in Hysterectomy: A Cost-Effectiveness Analysis of National Impact.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Trial of labor after previous single cesarean delivery in grand-multiparous women: a retrospective cohort study.Archives of gynecology and obstetrics · 2021Article
- Cost-effectiveness of Surgical Treatment Pathways for Prolapse.Female pelvic medicine & reconstructive surgery · 2021Article
- Intrapartum interventions that affect maternal and neonatal outcomes for vaginal birth after cesarean section.The Journal of international medical research · 2020Article
- Epidural Labor Analgesia Is Associated with a Decreased Risk of the Edinburgh Postnatal Depression Scale in Trial of Labor after Cesarean: A Multicenter, Prospective Cohort Study.BioMed research international · 2020Article
- Effect of epidural analgesia in trial of labor after cesarean on maternal and neonatal outcomes in China: a multicenter, prospective cohort study.BMC pregnancy and childbirth · 2019Article
- Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2018Article
- Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China: A Retrospective Study.Chinese medical journal · 2018Article
- Vaginal birth after caesarean versus elective repeat caesarean delivery after one previous caesarean section: a cost-effectiveness analysis in four European countries.BMC pregnancy and childbirth · 2018Article
- Cost-effectiveness Analysis of Intraoperative Cell Salvage for Obstetric Hemorrhage.Anesthesiology · 2018Article
- Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.BMC pregnancy and childbirth · 2018Article
- Women's reasons for, and experiences of, choosing a homebirth following a caesarean section.BMC pregnancy and childbirth · 2015Article
- Effect of multiple repeat cesarean sections on maternal morbidity: data from southeast Turkey.Medical science monitor : international medical journal of experimental and clinical research · 2015Article
- Lifetime cost-effectiveness of trial of labor after cesarean in the United States.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes ResearchArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElective repeat caesarean delivery (ERCD) rates have been increasing worldwide, thus prompting obstetric discourse on the risks and benefits for the mother and infant. Yet, these increasing rates also have major economic implications for the health care system. Given the dearth of information on the cost-effectiveness related to mode of delivery, the aim of this paper was to perform an economic evaluation on the costs and short-term maternal health consequences associated with a trial of labour after one previous caesarean delivery compared with ERCD for low risk women in Ireland.
methodsUsing a decision analytic model, a cost-effectiveness analysis (CEA) was performed where the measure of health gain was quality-adjusted life years (QALYs) over a six-week time horizon. A review of international literature was conducted to derive representative estimates of adverse maternal health outcomes following a trial of labour after caesarean (TOLAC) and ERCD. Delivery/procedure costs derived from primary data collection and combined both "bottom-up" and "top-down" costing estimations.
resultsMaternal morbidities emerged in twice as many cases in the TOLAC group than the ERCD group. However, a TOLAC was found to be the most-effective method of delivery because it was substantially less expensive than ERCD (€ 1,835.06 versus € 4,039.87 per women, respectively), and QALYs were modestly higher (0.84 versus 0.70). Our findings were supported by probabilistic sensitivity analysis.
conclusionsClinicians need to be well informed of the benefits and risks of TOLAC among low risk women. Ideally, clinician-patient discourse would address differences in length of hospital stay and postpartum recovery time. While it is premature advocate a policy of TOLAC across maternity units, the results of the study prompt further analysis and repeat iterations, encouraging future studies to synthesis previous research and new and relevant evidence under a single comprehensive decision model.
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