Trial of Labor After One Cesarean Section a Cross-sectional Study After Protocol Introduction

Trial of Labor After Cesarean

in 2015 a protocol for trail of labor after a single cesarean delivery was approved by medical committee of Pescara Hospital. A database from outpatient clinic evaluated all women after 34 weeks' gestation with a previous cesarean delivery. Patients with a specific medical indication for cesarean delivery were skipped, whilst the others were recruited within repetitive elective cesarean delivery or trial of labor based on maternal request. Patients were couselled on the opportunity of having a mechanical induction/ rupture of membranes and subsequent oxytocin infusion if needed due to prolonged gestation (above 41 weeks plus 3 days) or medical indication to delivery (i.e. gestational diabetes, hypertension, SGA, etc.)

All pregnant women with a previous CD attending Labor Ward of Santo Spirito Hospital of Pescara Italy (affiliated to University of Chieti Pescara) were enrolled at outpatient clinic after internal protocol registration for trial of labor in previus cesarean delivery. Patinets with a medical indication to CD were not elegible. Sociodemographic data such as ethnic background, maternal age, gestational age at delivery, previous vaginal birth, indications to previous CD, and maternal willingness to RECD ot TOLAC were recorded.

Maternal decision to switch to different intervention were recorded. Outcome of RECD and TOLAC were recorded.

Inclusion Criteria:

• pregnant women
• previous CD

Exclusion Criteria:

• below 34 weeks' gestation
• medical indication to CD