ArticleActa obstetricia et gynecologica Scandinavica2026
Nine years' experience of trial of labor after two previous cesarean sections at a tertiary hospital - A retrospective cohort study.
Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe global cesarean section (CS) rate has increased to 21.1% between 1990 and 2018. In Singapore, the annual CS rate has increased by ~ 0.6%, reaching an overall rate of 37.4%. Almost one-third of all cesarean deliveries are performed for at least one previous CS. Women with two CSs are often denied a "trial of vaginal delivery" due to the increased risk of uterine scar rupture. This study aims to examine maternal and neonatal outcomes of women undergoing trials of labor following two CSs (TOLAC-2). MATERIAL AND
methodsWe conducted a retrospective observational study of women with singleton, term pregnancies in cephalic presentation who underwent TOLAC-2 at the National University Hospital, Singapore, between September 2013 and June 2022. Data were obtained through a detailed review of electronic medical records.
resultsAmong 898 women with two previous CSs, 7.0% (63/898) attempted TOLAC-2, of whom 55.6% (35/63) achieved a successful vaginal birth (VBAC-2). Successful TOLAC-2 was associated with a significantly shorter duration of active labor (5.0 vs. 7.7 h, p = 0.013) and lower estimated blood loss (242mLs vs. 423mLs, p ≤ 0.001) compared with failed TOLAC-2. There were no perinatal complications of uterine rupture, APGAR <7 at 5 minutes, meconium aspiration syndrome or hypoxic-ischemic encephalopathy. We observed a trend toward successful VBAC-2 in women with a history of prior vaginal birth (74.6% vs. 48.9% p = 0.07).
conclusionsIn our cohort, more than half of the women attempting TOLAC-2 at term achieved a successful vaginal birth without serious perinatal or maternal complications. TOLAC-2 is a safe and reasonable option for appropriately selected women following adequate counseling, even in the absence of a prior vaginal delivery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.