Observational studyBMC pregnancy and childbirth2020
Reasons for previous Cesarean deliveries impact a woman's independent decision of delivery mode and the success of trial of labor after Cesarean.
Observational study in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Trial of Labor After Cesarean and Vaginal Birth After Cesarean: A Systematic Review and Meta-Analysis of Maternal and Neonatal Outcomes.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Predictors of successful vaginal birth after a cesarean section in Ethiopia: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Investigating the Success Rate of Vaginal Delivery After Cesarean Section and Its Associated Factors in Afghan Women: Insights from a Maternity Hospital in Kabul.International journal of women's health · 2025Article
- Cesarean delivery and its determining factors: A hospital-based study in Jashore District, Bangladesh.Public health in practice (Oxford, England) · 2024Article
- Caesarean section and respiratory system disorders in newborns.European journal of obstetrics & gynecology and reproductive biology: X · 2024Review
- Preferred mode of delivery and its associated factors in pregnant women with a previous cesarean scar at a tertiary care hospital in Ethiopia: institutional-based cross-sectional study.BMC pregnancy and childbirth · 2023Article
- Factors associated with successful vaginal birth after one lower uterine transverse cesarean section delivery.Scientific reports · 2023Article
- Association between hepatitis B virus replication during pregnancy and perinatal outcomes: a retrospective cohort study.Annals of medicine · 2023Article
- Factors associated with cesarean birth in nulliparous women: A multicenter prospective cohort study.Birth (Berkeley, Calif.) · 2022Article
- Geospatial analysis of cesarean section in Iran (2016-2020): exploring clustered patterns and measuring spatial interactions of available health services.BMC pregnancy and childbirth · 2022Article
- Planned mode of birth after previous cesarean section: A structured review of the evidence on the associated outcomes for women and their children in high-income setting.Frontiers in medicine · 2022Review
- Article
- Evaluation of factors that predict the success rate of trial of labor after the cesarean section.BMC pregnancy and childbirth · 2021Article
- Previous mode of delivery affects subsequent pregnancy outcomes: a Chinese birth register study.Annals of translational medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. To reveal the safety and feasibility of TOLAC, we conducted this observational, prospective study with women's independent decisions. We aimed to clarify the relationship between their chosen mode of delivery and the reason for their previous Cesarean. Additionally, we have tried to identify maternal and obstetric factors associated with failed TOLAC to improve its success rate.
methodsThis was a prospective, observational study of 1086 pregnant women with at least one previous Cesarean delivery. Of these, 735 women met our TOLAC criteria (Table 1), and then, could choose TOLAC or repeat Cesarean after receiving detailed explanations regarding the risks and benefits of both procedures. The primary outcomes were the number of successful TOLAC procedures and 5-min Apgar scores < 7 for the trial of labor after Cesarean group and elective Cesarean group. We collected the maternal and neonatal data including the reasons of previous Cesarean.
resultsIn total, 64.1% of women chose TOLAC. The success rate was 91.3%. The uterine rupture rate was 0.6%. There were no significant differences in the rate of Apgar scores at 5 min < 7 between both groups. Histories of experience of labor in previous Cesarean delivery were observed in 30 and 50% of women who chose TOLAC and repeat Cesarean, respectively (p < 0.05). Factors related to failed TOLAC included ≥40 weeks of gestation (odds: 5.47, 95% CI: 2.55-11.70) and prelabor rupture of membranes (PROM) (odds: 4.47, 95% CI: 2.07-9.63).
conclusionsTOLAC is a favorable delivery option for both mothers and neonates when women meet criteria and choose after receiving detailed explanations. Women who experience PROM or ≥ 40 weeks of gestation, their modes of delivery should be reconsulted.
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