[ozmidwifery] FYI

[Mary Murphy]

VBAC risks not elevated post term Source: Obstetrics & Gynecology 2005; 106: 700-6 Comparing the risk of failure and major complications after a vaginal birth after cesarean when performed before and after the estimated date of delivery. Vaginal birth after cesarean (VBAC) can be safely attempted in women beyond 40 weeks gestation, but the likelihood of success is reduced, say researchers. "Although VBAC data have been examined in different patient populations and clinical scenarios, little has been published about VBAC attempts in women whose pregnancy has reached or extended past the estimated date of delivery," note Kara Coassolo (Hospital of the University of Pennsylvania, Philadelphia, USA) and colleagues. For the current study, the team used retrospective data for 11,587 women who attempted VBAC at one of 17 hospitals over a 5-year period. They found that cesareans VBAC in women who were beyond 40 weeks' gestation were significantly more likely to fail than those carried out earlier. However, the risk of uterine rupture and overall morbidity was not significantly increased. Based on their research, Coassolo et al say practitioners "can counsel women that the chances of VBAC success are decreased in gestations that continue beyond the estimated date of delivery compared with those before 40 weeks." However, patients can be reassured that the success rate is still quite good, at 70 percent, and that the risks are not increased "simply because the due date has passed." Posted: 5 October 2005