Evidence map›Paper›PMID 37389641›Full record

ArticleArchives of gynecology and obstetrics2024

The association between trial of labor after cesarean in obese patients and adverse maternal outcomes.

Gabrielle Jude, Audra Fain, Christina Raker, Shayna Rubenstein, Matthew Bicocca, Stephen Wagner, Megha Gupta

Abstract read
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In one paragraph

Article in Archives of gynecology and obstetrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. 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 · 2025
    Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gabrielle JudeDepartment of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA.
Audra FainDepartment of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA.
Christina RakerDepartment of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA.
Shayna RubensteinDepartment of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA.
Matthew BicoccaDepartment of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Stephen WagnerDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA. smw5120@gmail.com.ORCID http://orcid.org/0000-0002-2715-2755
Megha GuptaDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe hypothesized that among obese patients with a history of cesarean birth, a TOLAC is associated with decreased composite maternal adverse outcomes (CMAO) compared to planned repeat low transverse cesarean section (RLTCS).

methodsIn this population-based cross-sectional study using the National Birth Certificate database from 2016 to 2020, we compared obese patients who attempted TOLAC at term (≥ 37 weeks estimated gestational age) to planned RLTCS. The primary outcome was a CMAO, defined as delivery complications, including intensive care unit (ICU) admission, uterine rupture, unplanned hysterectomy, or maternal blood transfusion.

resultsOverall, 794,278 patients met inclusion criteria for the study; 126,809 underwent a TOLAC, and 667,469 had a planned RLTCS. The overall CMAO was significantly higher for patients undergoing TOLAC (9.0 per 1000 live births) compared to RLTCS (5.3 per 1000 live births; aRR 1.64, 95% CI 1.53-1.75).

conclusionThis data demonstrate that in obese patients with prior cesarean birth, a trial of labor is associated with increased maternal morbidity when compared to a planned repeat cesarean birth.

Indexed as

Cesarean Section, RepeatObesityTrial of LaborVaginal Birth after CesareanAdultCesarean SectionCross-Sectional StudiesFemaleHumansPregnancyPregnancy ComplicationsPregnancy OutcomeUterine RuptureMaternal morbidityObesityTOLAC

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.