ArticleBMC pregnancy and childbirth2017
Maternal and perinatal outcome after previous caesarean section in rural Rwanda.
Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Socioeconomic, demographic and obstetric determinants of maternal near miss in Africa: A systematic review.PloS one · 2025Pooled it
- Correlation Between Previous Caesarean Section and Adverse Maternal Outcomes Accordingly With Robson Classification: Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2019Pooled it
- Caesarean section Robson classification, complications, and lessons learned in a rural hospital in Walikale, North Kivu, Democratic Republic of Congo: a cross-sectional study.AJOG global reports · 2026Article
- Outcomes and Risk Factors for Failed Trial of Labour After One Previous Caesarean Section in Selected Private Hospitals in Mogadishu, Somalia: An Unmatched Case-Control Study.International journal of women's health · 2026Article
- Preference and determinants of delivery mode in pregnant women with one cesarean scar: a cross-sectional study in two urban Ugandan public hospitals.BMC pregnancy and childbirth · 2025Article
- Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study.BMC pregnancy and childbirth · 2024Article
- High Rates of Repeated Caesarean Section Deliveries and its Associated Maternal and Foetal Complications at A Tertiary Hospital in Northern Tanzania.The East African health research journal · 2024Article
- Association between first birth caesarean delivery and adverse maternal-perinatal outcomes in the second pregnancy: a registry-based study in Northern Tanzania.BMC pregnancy and childbirth · 2022Article
- Prevalence and factors associated with caesarean section in Rwanda: a trend analysis of Rwanda demographic and health survey 2000 to 2019-20.BMC pregnancy and childbirth · 2022Article
- Repeat Cesarean Section among Pregnant Women in a Tertiary Center of Nepal: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2022Article
- Risk Factors Associated with Uterine Rupture and Dehiscence: A Cross-Sectional Canadian Study.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2021Article
- Impact of Medical Doctors Global Health and Tropical Medicine on decision-making in caesarean section: a pre- and post-implementation study in a rural hospital in Malawi.Human resources for health · 2020Article
- Maternal and fetal outcomes of cesarean delivery and factors associated with its unfavorable management outcomes; in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017.BMC research notes · 2019Article
- Feto-maternal Outcomes of Emergency Caesarean Section following Residential Posting at Dhading District Hospital.JNMA; journal of the Nepal Medical AssociationArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOffering a trial of labor (ToL) after previous caesarean section (CS) is an important strategy to reduce short- and long-term morbidity associated with repeated CS. We compared maternal and perinatal outcomes between ToL and elective repeat caesarean section (ERCS) at a district hospital in rural Rwanda.
methodsAudit of women's records with one prior CS who delivered at Ruhengeri district hospital in Rwanda between June 2013 and December 2014.
resultsOut of 4131 women who came for delivery, 435 (11%) had scarred uteri. ToL, which often started at home or at health centers without appropriate counseling, occurred in 297/435 women (68.3%), while 138 women (31.7%) delivered by ERCS. ToL was successful in 134/297 (45.1%) women. There were no maternal deaths. Twenty-eight out of all 435 women with a scarred uterus (6.4%) sustained severe acute maternal morbidity (puerperal sepsis, postpartum hemorrhage, uterine rupture), which was higher in women with ToL (n = 23, 7.7%) compared with women who had an ERCS (n = 5, 3.6%): adjusted odds ration (aOR) 1.4 (95% CI 1.2-5.4). There was no difference in neonatal admissions between women who underwent ToL (n = 64/297; 21.5%) and those who delivered by ERCS (n = 35/138; 25.4%: aOR 0.8; CI 0.5-1.6). The majority of admissions were due to perinatal asphyxia that occurred more often in infants whose mothers underwent ToL (n = 40, 13.4%) compared to those who delivered by ERCS (n = 15, 10.9%: aOR 1.9; CI 1.6-3.6). Perinatal mortality was similar among infants whose mothers had ToL (n = 8; 27/1000 ToLs) and infants whose mothers underwent ERCS (n = 4; 29/1000 ERCSs).
conclusionsA considerable proportion of women delivering at a rural Rwandan hospital had scarred uteri. Severe acute maternal morbidity was higher in the ToL group, perinatal mortality did not differ. ToL took place under suboptimal conditions: access for women with scarred uteri into a facility with 24-h surgery should be guaranteed to increase the safety of ToL.
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