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Trial of labor after cesarean delivery for estimated large for gestational age fetuses: A retrospective cohort study.
Mohr-Sasson, Aya; Bercovich, Or; Goichberg, Zohar; Watad, Hadel; Salim, Kiss; Mazaki-Tovi, Shali; Sivan, Eyal; Hendler, Israel.
Afiliación
  • Mohr-Sasson A; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Bercovich O; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: orbercovich@mail.tau.ac.il.
  • Goichberg Z; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Watad H; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Salim K; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Mazaki-Tovi S; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Sivan E; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Hendler I; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Gynecol Obstet Hum Reprod ; 51(10): 102494, 2022 Dec.
Article en En | MEDLINE | ID: mdl-36309341
OBJECTIVE: Although ultrasonographic estimation of fetal weight ≥90th percentile is not associated with a greater risk for uterine rupture, trial of labor after cesarean delivery (TOLAC) is considered relatively contraindicated for macrosomic fetuses. Hence, when an estimated fetal weight of 4000 g is detected, TOLAC is usually avoided.Our aim was to evaluate the obstetrical outcome and safety of TOLAC in women with estimated large for gestational age fetuses (eLGA) (≥90th percentile). STUDY DESIGN: Our retrospective cohort study encompassed all pregnant women with an estimated fetal weight ≥90th percentile for gestational age, admitted to a single tertiary care center between January 2012-July 2017 for TOLAC. RESULTS: 1949 women met the inclusion criteria; 78 (4%) eLGA and 1871 (96%) controls. Fifty-five (70.5%) women in the study group had experienced a successful vaginal delivery compared to 1506 (80.5%) of the controls (p = 0.03). The rate of obstetrical complications, including scar dehiscence, uterine rupture, a 3rd/4th degree perineal tear or shoulder dystocia were comparable. The rate of post-partum hemorrhage (PPH) increased in the study group compared to the controls (7.7 % vs.1.7%; p = 0.001). CONCLUSION: TOLAC for eLGA fetuses can be considered safe, however, lower successful rates of vaginal births after a cesarean delivery and an increased PPH rate, may be expected.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotura Uterina / Parto Vaginal Después de Cesárea / Hemorragia Posparto Tipo de estudio: Etiology_studies / Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Pregnancy Idioma: En Revista: J Gynecol Obstet Hum Reprod Año: 2022 Tipo del documento: Article País de afiliación: Israel Pais de publicación: Francia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotura Uterina / Parto Vaginal Después de Cesárea / Hemorragia Posparto Tipo de estudio: Etiology_studies / Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Pregnancy Idioma: En Revista: J Gynecol Obstet Hum Reprod Año: 2022 Tipo del documento: Article País de afiliación: Israel Pais de publicación: Francia