Trial of Labor and Vaginal Birth after Three Previous Cesarean Sections: Report of Two Special Cases

Abstract

Background Natural childbirth could represent a deeply rooted need for many women, even in exceptional situations such as after 3 previous caesarean sections.

Case presentation The first patient, a 28-year-old 6^th gravida and 3^rd para, first presented in the 40+3 week of pregnancy desiring a vaginal birth, after all the other hospitals in the area had refused her request. A detailed explanation of potential risks was given and, when 2 days later contractions started, she gave birth to a newborn of 4450 g spontaneously, without complications. A month later, a second woman, 42 years old, 5^th gravida, 3^rd para, read about the above-mentioned case on social media and decided to attempt a natural delivery after 3 caesarean sections at our hospital as well. She presented herself for the first time in the 41+1 week of pregnancy in our delivery room with an onset of labor after rupture of the membranes and gave birth on the same day, spontaneously without complications, to a 4150 g heavy healthy newborn.

Conclusions The wish to attempt a spontaneous birth after 3 previous caesarean sections can be deeply anchored and should be professionally approached by obstetricians, even if counseling and management can be challenging.

Key words

Natural childbirth - cesarean section - vaginal birth after cesarean section - uterine rupture - uterine scar - social media

Publikationsverlauf

Eingereicht: 26. Januar 2021

Angenommen nach Revision: 31. August 2021

Artikel online veröffentlicht:
10. Januar 2022

• References

• 1 Lothian JA. Why natural childbirth?. J Perinat Educ 2000; 9: 44-46
• 2 Fruscalzo A, Salmeri MG, Cendron A. et al. Introducing routine trial of labour after caesarean section in a second level hospital setting. J Matern Fetal Neonatal Med 2012; 25: 1442-1446
• 3 Sandall J, Tribe RM, Avery L. et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet Lond Engl 2018; 392: 1349-1357
• 4 Chen S-W, Hutchinson AM, Nagle C. et al. Women’s decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study. BMC Pregnancy Childbirth 2018; 18: 31
• 5 Munro S, Janssen P, Corbett K. et al. Seeking control in the midst of uncertainty: women’s experiences of choosing mode of birth after caesarean. Women Birth J Aust Coll Midwives 2017; 30: 129-136
• 6 Landon MB, Spong CY, Thom E. et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol 2006; 108: 12-20
• 7 Spaans WA, van der Vliet LM, Roell-Schorer EA. et al. Trial of labour after two or three previous caesarean sections. Eur J Obstet Gynecol Reprod Biol 2003; 110: 16-19
• 8 Emembolu JO. Vaginal delivery after two or more previous caesarean sections: is trial of labour contraindicated?. J Obstet Gynaecol 1998; 18: 20-24
• 9 Miller DA, Diaz FG, Paul RH. Vaginal birth after cesarean: a 10-year experience. Obstet Gynecol 1994; 84: 255-258
• 10 Hansell RS, McMurray KB, Huey GR. Vaginal birth after two or more cesarean sections: a five-year experience. Birth 1990; 17: 146-150 discussion 150–151
• 11 Novas J, Myers SA, Gleicher N. Obstetric outcome of patients with more than one previous cesarean section. Am J Obstet Gynecol 1989; 160: 364-367
• 12 Pruett KM, Kirshon B, Cotton DB. et al. Is vaginal birth after two or more cesarean sections safe?. Obstet Gynecol 1988; 72: 163-165
• 13 Stovall TG, Shaver DC, Solomon SK. et al. Trial of labor in previous cesarean section patients, excluding classical cesarean sections. Obstet Gynecol 1987; 70: 713-717
• 14 Riva HL, Teich JC. Vaginal delivery after cesarean section. Am J Obstet Gynecol 1961; 81: 501-510
• 15 Sharma S, Thorpe-Beeston JG. Trial of vaginal delivery following three previous caesarean sections. BJOG 2002; 109: 350-351
• 16 Bowyer L, Chapman M. Successful vaginal birth after three previous Caesarean sections with no prior labour. Aust N Z J Obstet Gynaecol 2003; 43: 471-472
• 17 Lawson GW. Vaginal delivery after 3 previous caesarean sections. Aust N Z J Obstet Gynaecol 1987; 27: 115-116
• 18 Farmakides G, Duvivier R, Schulman H. et al. Vaginal birth after two or more previous cesarean sections. Am J Obstet Gynecol 1987; 156: 565-566
• 19 Cahill AG, Tuuli M, Odibo AO. et al. Vaginal birth after caesarean for women with three or more prior caesareans: assessing safety and success. BJOG 2010; 117: 422-427
• 20 Vigorito R, Montemagno R, Saccone G. et al. Obstetric outcome associated with trial of labor in women with three prior cesarean delivery and at least one prior vaginal birth in an area with a particularly high rate of cesarean delivery. J Matern Fetal Neonatal Med 2016; 29: 3741-3743
• 21 Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2) – a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010; 117: 5-19
• 22 ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol 2010; 116: 450-463