Trial reportBJOG : an international journal of obstetrics and gynaecology2022
How does uterine contractile activity affect the success of trial of labour after caesarean section, and the risk of uterine rupture? An exploratory, blinded analysis of a cohort from a randomised controlled trial.
Trial report in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Intrauterine Contraction Monitoring in Chorioamnionitis: A Secondary, Blinded Analysis of a Randomised Controlled Trial Cohort.BJOG : an international journal of obstetrics and gynaecology · 2025Trial
- Uterine contractile activity and neonatal outcome - A blind analysis of a randomized controlled trial cohort.Acta obstetricia et gynecologica Scandinavica · 2024Trial
- Second-trimester anthropometric estimators of cesarean section: the agreement between body roundness index, body mass index, body fat percentage, and waist circumference.BMC pregnancy and childbirth · 2025Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo investigate the impact of uterine contractile activity on the outcome of trial of labour after caesarean section (TOLAC).
designSecondary, blinded analyses of a prospective TOLAC cohort.
settingTwo labour wards, one in a university tertiary hospital and the other in a central hospital. POPULATION: A total of 194 TOLAC parturients with intrauterine tocodynamometry during labour.
methodsAnalysis of intrauterine pressure, frequency of contractions and baseline tonus of uterine muscle in 30-minute periods for 4 hours before birth.
main outcome measuresPrimary outcome: uterine contractile activity during TOLAC. Secondary aims: contributors associated with failed TOLAC and uterine rupture.
resultsTOLAC succeeded in 74% of cases. Uterine contractile activity, expressed as intrauterine pressure, was significantly higher in successful TOLAC compared with failed TOLAC (210 versus 170 Montevideo units). The statistically significant risk factors of failed TOLAC, after multivariate regression analysis, were prolonged gestational age, reduced cervical dilatation at admission and lower mean intrauterine pressure. In cases of uterine rupture, contractile activity did not differ from that in failed TOLAC. Cervical ripening with a Foley catheter appeared to be a risk factor for uterine rupture, as well as cervical dilatation <3 cm at admission. The incidence of total uterine rupture was 2.6% (n = 5).
conclusionsWomen with successful vaginal birth had higher uterine contractile activity than those experiencing failed TOLAC or uterine rupture despite similar use of oxytocin. Induction of labour with a Foley catheter turned out to be a risk factor for uterine rupture during TOLAC among parturients with no previous vaginal delivery. TWEETABLE ABSTRACT: During VBAC the response to oxytocin, assessed as intrauterine pressure, is greater and adequate, in contrast to failed TOLAC.
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