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Vaginal Birth After Cesarean in German Out‐of‐Hospital Settings: Maternal and Neonatal Outcomes of Women With Their Second Child

  • Background To offer vaginal birth after cesarean (VBAC) in a hospital setting is recommended in international guidelines, but offering VBAC in out‐of‐hospital settings is considered controversial. This study describes neonatal and maternal outcomes in mothers who started labor in German out‐of‐hospital settings. Method In a retrospective analysis of German out‐of‐hospital data from 2005 to 2011, included were 24,545 parae II with a singleton pregnancy in a cephalic presentation at term (1,927 with a prior cesarean and 22,618 with a prior vaginal birth). Result The overall VBAC rate was 77.8 percent. The intrapartum transfer rate to hospital was 38.3 percent (prior cesarean) versus 4.6 percent (prior vaginal) (p < 0.05), and the 10‐minute Apgar < 7 rate was 0.6 versus 0.2 percent (p < 0.05), and the nonemergency intrapartum transfer rate was 91.5 versus 85.0 percent (p < 0.05). Prolonged first stage of labor was the most common reason for intrapartum transfer in both groups. The leading reason for postpartum transfer was retained placenta. Discussion There was a high rate of successful VBAC in this study. The high nonemergency transfer rate for women with VBAC might mean that midwives are more cautious when attending women with a prior cesarean in out‐of‐hospital settings. Further studies are necessary to evaluate which women are suitable for VBAC in out‐of‐hospital settings.

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Metadaten
Author:Sabine Metzing, Claudia Hellmers
Title (English):Vaginal Birth After Cesarean in German Out‐of‐Hospital Settings: Maternal and Neonatal Outcomes of Women With Their Second Child
DOI:https://doi.org/10.1111/birt.12130
Parent Title (English):Birth
Document Type:Article
Language:English
Year of Completion:2014
electronic ID:Zur Anzeige in scinos
Release Date:2018/08/16
Volume:41
Issue:4
First Page:309
Last Page:315
Faculties:Fakultät WiSo
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion