ArticleThe journal of obstetrics and gynaecology research2022
Trial of labor after two cesarean sections: A retrospective case-control study.
Article in The journal of obstetrics and gynaecology research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- FIGO good practice recommendations for vaginal birth after cesarean section.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Nine years' experience of trial of labor after two previous cesarean sections at a tertiary hospital - A retrospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Successful Trial of Labor After Two Caesarean Sections (TOLA2C): Analysis of a Delivery Protocol with Feto-Maternal Outcome.Geburtshilfe und Frauenheilkunde · 2025Article
- Combined cesarean section and myomectomy increases perioperative risks and affects postpartum recovery in women with uterine fibroids during late pregnancy.American journal of translational research · 2025Article
- Trial of labour after two caesarean sections (TOLA2C) and risk of uterine rupture, a retrospective single centre study.BMC pregnancy and childbirth · 2024Article
- Application of the Robson classification in assessing cesarean section rates: an audit of a tertiary care hospital's gynecology department in Karachi, Pakistan.Therapeutic advances in reproductive healthArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe objective of this study was to compare neonatal and maternal outcomes among women with two previous cesarean deliveries who undergo trial of labor after two cesarean section (TOLA2C) versus elective repeat cesarean delivery (ERCD). Our primary outcome was neonatal intensive care unit (NICU) admission. Secondary outcomes included APGAR score <7 at 5 min, TOLA2C success rate, uterine rupture, postpartum hemorrhage, maternal blood transfusion, maternal bowel and bladder injury, immediate postpartum infection, and maternal mortality.
methodsThis retrospective cohort study was undertaken at a community medical center from January 1, 2008 to December 31, 2018. Inclusion criteria were women with a vertex singleton gestation at term and a history of two prior cesarean sections. Exclusion criteria included a previous successful TOLA2C, prior classical uterine incision or abdominal myomectomy, placenta previa or invasive placentation, multiple gestation, nonvertex presentation, history of uterine rupture or known fetal anomaly. Maternal and neonatal outcomes were assessed using Fisher exact test and Wilcoxon rank sum test.
resultsA total of 793 patients fulfilled study criteria. There were no differences in neonatal intensive care unit admissions or 5-min APGAR scores <7 between the two groups. Sixty-eight percent of women who underwent TOLAC (N = 82) had a successful vaginal delivery. The uterine rupture rate was 1.16% (N = 1) in the TOLA2C group with no case of uterine rupture in the ERCD group. No difference in maternal morbidity was noted between the two groups. No maternal or neonatal mortalities occurred in either group.
conclusionsThere was no difference in maternal or neonatal morbidity among patients in our study population with two previous cesarean sections who opted for TOLA2C versus ERCD.
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