Hey everyone, sorry but I had to cut this down for copyright concerns on the site, but the whole thing can be found in the February issue of the Journal of Obstetrics and Gynecology. All italics and underlinings are my own.
Prior Successful Vaginal Birth After Cesarean Delivery Linked to Low Risk for Complications in Later Attempts CME/CE
News Author: Laurie Barclay, MD
CME Author: Désirée Lie , MD , MSEd
Release Date: February 8, 2008;
February 8, 2008 — Women with previous successful attempts at vaginal birth after cesarean delivery (VBAC) are at low risk for maternal and neonatal complications during subsequent VBAC attempts, according to the results of a study reported in the February issue of Obstetrics & Gynecology ... Using a prospective, multicenter registry encompassing 19 clinical centers from 1999 to 2002, the investigators selected 13,532 women with 1 or more previous low transverse cesarean deliveries who attempted VBAC in their current pregnancy. They compared outcomes based on the number of previous VBAC attempts after the last cesarean delivery.
With an increasing number of previous VBACs, the success of VBAC increased: 63.3%, 87.6%, 90.9%, 90.6%, and 91.6% for those with 0, 1, 2, 3, and 4 or more previous VBACs, respectively (P < .001). After the first successful VBAC, the rate of uterine rupture decreased, and it did not increase thereafter: 0.87%, 0.45%, 0.38%, 0.54%, 0.52%, respectively (P =.03), and the risk for uterine dehiscence and other peripartum complications also decreased. With an increasing number of VBACs thereafter, there was no increase in neonatal morbidities.