The risk of uterine quarrel from va...

The risk of uterine quarrel from vaginal birth after cesarean delivery is relatively grave according to findings from the Agency for Healthcare Research and Quality (AHRQ). "Vaginal Birth After Cesarean" is available online at http://www.ahrq. gov/clinic/epcsums/vbacsum.htm.

Nearly 23 percent of births in the United States in 2000 occurr from cesarean delivery; this is the highest rate reported since data collection began in 1989 The rate of vaginal deliveries in women with previous cesarean deliveries decreased 27 percent from 1996 to 2000

A meta-analysis by way of the AHRQ found that rates of vaginal delivery in women with a previous cesarean delivery who attempt a trial of labor range from 60 to 82 percent Although data upon the effects of labor induction and augmentation are limited, oxytocin use is associated with a 10 percent reduction in the likelihood of vaginal delivery.

A randomized controll trial showed that radiographic pelvimetry is not able to reliably predict the way of delivery. Imaging studies that combine measurements of the pelvis and fetus display promising results but are limited according to their failure to control for confounding factors.

Maternal mortality rates do not differ between women who attempt labor and women who fix upon to undergo a repeat cesarean delivery, and evidence put in mind ofs that hysterectomy rates also do not differ between the arranges Infection rates are higher in women who have cesarean deliveries; evidence is inconsistent about the tenors of labor induction on infection rates. The risk of perinatal death in infants of women attempting labor is unclear, and there is insufficient evidence to make conclusions about the import of route of delivery onward Apgar score and respiratory comorbidity.

The rate of asymptomatic uterine break is equal in women attempting labor and women who prefer a repeat cesarean delivery. However, symptomatic uterine contention is significantly more common in women attempting labor. Based forward severity and frequency of symptomatic uterine break the risk of perinatal death from feud of a uterine scar is 15 through 10,000; the risk of maternal hysterectomy is 48 by 10,000.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group