National Institute of Child Health and Human Development
Maternal Fetal Medicine Units Network

An Observational Study of Cesarean Section and
Vaginal Birth after Cesarean Section

Related Publications & Presentations

Objective

1. To determine the patient characteristics of women undergoing a trial of labor (TOL) and to determine the efficacy and safety of trial of labor.
2. To determine the cesarean delivery rates, indications for operative intervention, intrapartum patient management and outcome by payer and provider status.
3. To estimate the frequency of maternal and neonatal complications of cesarean delivery.
4. To determine factors influencing maternal and neonatal outcome in women undergoing cesarean delivery.

Conclusion

To be determined

Clinical Centers

Magee Womens, Tennessee, Alabama, Wayne State, Cincinnati, Wake Forest, Chicago, Ohio State, U of Miami, UTSW, UT-San Antonio, Utah, Thomas Jefferson, Brown, Columbia, Case Western, UT-Houston, UNC, Northwestern

Design

• Type
• Registry
• Major Eligibility Criteria
• Cesarean section or successful VBAC
• ≥ 500 grams or ≥ 20 wks gestation
• Sample Size
• 10,800 TOL w/ 1 prior c-section
• 1,200 TOL w/ > 1 prior c-section

Scheduled Evaluations/Data Collections

• All deliveries
• Daily count of c-sections/VBAC and non VBAC vaginal deliveries

Enrolled patients

• Delivery:
• Chart review for physical history, demographics, current and previous pregnancy history, pregnancy complications, labor and delivery, cesarean delivery
• Post delivery:
• Maternal chart review for postpartum complications, evaluations, ICU admission, death
• Review of hospital admissions database for readmissions

Neonatal:

• Infant chart review for neonatal data, NICU admssions

Outcome Measures

• Primary
• Uterine rupture
• Secondary
• Maternal morbidity and mortality
• Neonatal morbidity and mortality

Timetable

• Recruitment: 1/99-1/02
• Data Collection: 1/996-7/02
• Closeout/Final Analysis: 7/02-1/03