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This study is a multi-center, prospective, observational clinical trial study. 510 full-term pregnant women will be enrolled as subjects, and the ratio of eligible subjects in the two groups is 1:1. In the cesarean section group, full term pregnant women with one prior cesarean section after spontaneous labor who are willing to try the trial of labor after cesarean (TOLAC) and in accordance with the criteria according to the 2016 China vaginal birth after cesarean (VBAC) clinical management guidelines will be enrolled and recorded by our homemade registration form of TOLAC. In the non-cesarean section group, pregnant women after 37 weeks of gestation after spontaneous labor but without vaginal labor contraindications will be enrolled. After spontaneous labor for 24h, their final delivery mode will be recorded. In the following 42 days postpartum, their complications and the neonatal outcome will be followed up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cesarean section group |
| ||
| Non-cesarean section group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non intervention | Other | If the vaginal delivery is failed after spontaneous labor for up to 24h, they will receive cesarean section |
|
| Measure | Description | Time Frame |
|---|---|---|
| Vignial birth rate | After spontaneous labor for up tp 24h, the mode of delivery will be konwn and recorded. | 24 hours |
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Inclusion Criteria:
Exclusion criteria:
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In the cesarean section group, the extra inclusion criteria includes: Only one prior low transverse uterine incision;Extra exclusion criteria:1. With mutiple history of c esction;2. Prior extensive transfundal uterine surgery, such as for fetal surgery, myomectomy, or uterine reconstruction; Prior classical vertical uterine incision, or an inverted "T" or "J" incision;3. Short interpregnancy interval;4.Prior uterine rupture or dehiscence, or cesarean scar pregnancy;4.Evaluated fetal birth weight> 4000 g.
In the non-cesarean section group, the extra criteria should include: nulliparous
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jiang Ziyan, Ph.D | Contact | 13512534017 | zyjiangchm@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Jiang Ziyan, Ph.D | Department of Obstetrics and Gynecology, First Affiliated Hospital of Nanjing Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Affiliated Hospital of Nanjing Medical University | Recruiting | Nanjing | Jiangsu | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29365328 | Background | Lassey SC, Robinson JN, Kaimal AJ, Little SE. Outcomes of Spontaneous Labor in Women Undergoing Trial of Labor after Cesarean as Compared with Nulliparous Women: A Retrospective Cohort Study. Am J Perinatol. 2018 Jul;35(9):852-857. doi: 10.1055/s-0037-1619448. Epub 2018 Jan 24. | |
| 23307166 | Background | Al-Shaikh G, Al-Mandeel H. The outcomes of trial of labour after cesarean section following induction of labour compared to spontaneous labour. Arch Gynecol Obstet. 2013 Jun;287(6):1099-103. doi: 10.1007/s00404-013-2709-z. Epub 2013 Jan 11. |
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