Maternal Morbidity following Trial of Labor after Cesarean in Women Experiencing Antepartum Fetal Death.

Ela Kadish, Tzuria Peled, Hen Y Sela, Ari Weiss, Shaked Shmaya, Sorina Grisaru-Granovsky, Misgav Rottenstreich

Abstract readMulticenter Study

In one paragraph

Article in Reproductive sciences (Thousand Oaks, Calif.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ela Kadish *Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Tzuria Peled *Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Hen Y SelaDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Ari WeissDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Shaked ShmayaFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Sorina Grisaru-GranovskyDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Misgav RottenstreichDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel. misgavr@gmail.com.ORCID 0000-0003-4875-1455

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aims to investigate whether trial of labor after cesarean delivery (TOLAC) in women with antepartum fetal death, is associated with an elevated risk of maternal morbidity. A retrospective multicenter. TOLAC of singleton pregnancies following a single low-segment incision were included. Maternal adverse outcomes were compared between women with antepartum fetal death and women with a viable fetus. Controls were matched with cases in a 1:4 ratio based on their previous vaginal births and induction of labor rates. Univariate analysis was followed by multiple logistic regression modeling. During the study period, 181 women experienced antepartum fetal death and were matched with 724 women with viable fetuses. Univariate analysis revealed that women with antepartum fetal death had significantly lower rates of TOLAC failure (4.4% vs. 25.1%, p < 0.01), but similar rates of composite adverse maternal outcomes (6.1% vs. 8.0%, p = 0.38) and uterine rupture (0.6% vs. 0.3%, p = 0.56). Multivariable analyses controlling for confounders showed that an antepartum fetal death vs. live birth isn't associated with the composite adverse maternal outcomes (aOR 0.96, 95% CI 0.21-4.44, p = 0.95). TOLAC in women with antepartum fetal death is not associated with an increased risk of adverse maternal outcomes while showing high rates of successful vaginal birth after cesarean (VBAC).

Indexed as

Fetal DeathTrial of LaborVaginal Birth after CesareanAdultFemaleHumansPregnancyPregnancy OutcomeRetrospective StudiesRisk FactorsCesarean deliveryFetal deathFetal demiseStillbirthTrial of laborUterine rupture

Identifiers

PMID38992258

DOI10.1007/s43032-024-01645-1

PMCPMC11438716

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