Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2020; 10(01): e37-e41
DOI: 10.1055/s-0040-1702924
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is Early Amniotomy Associated with Higher Likelihood of Vaginal Birth after Cesarean?

Megan S. Varvoutis
1   Division of Maternal Fetal Medicine, Department of OBGYN, Duke University, Durham, North Carolina
,
Lauren C. Sayres
1   Division of Maternal Fetal Medicine, Department of OBGYN, Duke University, Durham, North Carolina
,
Sarah K. Dotters-Katz
1   Division of Maternal Fetal Medicine, Department of OBGYN, Duke University, Durham, North Carolina
› Author Affiliations Funding None.
Further Information

Publication History

30 April 2019

10 November 2019

Publication Date:
04 March 2020 (online)

Also available at
   Permissions and Reprints

Abstract

Objective The study aims to reduce cesarean rates, eligible women are being offered an option of vaginal birth after cesarean (VBAC). However, little data exist regarding efficacy of amniotomy as a tool in this population. We sought to evaluate the impact of early amniotomy on VBAC success.

Study Design This is a secondary analysis case-control study using the MFMU (Maternal-Fetal Medicine Units Network) Cesarean Registry. Women were included if they had a singleton pregnancy, were attempting VBAC, and underwent induction with artificial rupture of membranes. Cases were defined as subjects with successful VBAC; controls were defined as subjects with failed trial of labor after cesarean (TOLAC). Early amniotomy was defined as amniotomy at <4 cm. Demographic and obstetric characteristics were compared and multivariate logistic regression was performed.

Results A total of 1,490 women were included. Early amniotomy occurred in 59.5% with VBAC versus 63.2% with failed TOLAC (p = 0.24). After controlling for body mass index, prior vaginal delivery, African–American race, labor length, gestational age, birthweight, epidural use, Foley catheter balloon ripening, induction method and oxytocin use, early amniotomy was associated with a 34% decrease in VBAC success (p < 0.01). Women who had early amniotomy did not have higher rates of chorioamnionitis (2.8 vs. 2.9%, p > 0.99).

Conclusion Unlike data from nulliparous women, our data suggest that induction with early amniotomy does not increase the likelihood of VBAC.

Keywords

induction - amniotomy - TOLAC - vaginal birth after cesarean
 

  • References

  • 1 Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: final data for 2016. Natl Vital Stat Rep 2018; 67 (01) 1-55
    PubMedGoogle Scholar
  • 2 Landon MB, Hauth JC, Leveno KJ. , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med 2004; 351 (25) 2581-2589
    CrossrefPubMedGoogle Scholar
  • 3 Macones GA, Peipert J, Nelson DB. , et al. Maternal complications with vaginal birth after cesarean delivery: a multicenter study. Am J Obstet Gynecol 2005; 193 (05) 1656-1662
    CrossrefPubMedGoogle Scholar
  • 4 Martin JA, Hamilton BE, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2012. Natl Vital Stat Rep 2013; 62 (09) 1-68
    PubMedGoogle Scholar
  • 5 ACOG Practice Bulletin No. ACOG practice bulletin no. 205: vaginal birth after cesarean delivery. Obstet Gynecol 2019; 133 (02) e110-e127
    CrossrefPubMedGoogle Scholar
  • 6 Fraser WD, Marcoux S, Moutquin JM, Christen A. ; The Canadian Early Amniotomy Study Group. Effect of early amniotomy on the risk of dystocia in nulliparous women. N Engl J Med 1993; 328 (16) 1145-1149
    CrossrefPubMedGoogle Scholar
  • 7 Zhang J, Branch DW, Ramirez MM. , et al. Oxytocin regimen for labor augmentation, labor progression, and perinatal outcomes. Obstet Gynecol 2011; 118 (2 Pt 1): 249-256
    CrossrefPubMedGoogle Scholar
  • 8 Shah U, Bellows P, Drexler K. , et al. Comparison of induction of labor methods for unfavorable cervices in trial of labor after cesarean delivery. J Matern Fetal Neonatal Med 2017; 30 (09) 1010-1015
    CrossrefPubMedGoogle Scholar
  • 9 Grobman WA, Lai Y, Landon MB. , et al; National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU). Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol 2007; 109 (04) 806-812
    CrossrefPubMedGoogle Scholar
  • 10 Macones GA, Cahill A, Stamilio DM, Odibo AO. The efficacy of early amniotomy in nulliparous labor induction: a randomized controlled trial. Am J Obstet Gynecol 2012; 207 (05) 403.e1-403.e5
    CrossrefPubMedGoogle Scholar
  • 11 Landon MB, Leindecker S, Spong CY. , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. The MFMU Cesarean Registry: factors affecting the success of trial of labor after previous cesarean delivery. Am J Obstet Gynecol 2005; 193 (3 Pt 2): 1016-1023
    CrossrefPubMedGoogle Scholar
  • 12 Caughey AB, Shipp TD, Repke JT, Zelop C, Cohen A, Lieherman E. Trial of labor after cesarean delivery: the effect of previous vaginal delivery. Am J Obstet Gynecol 1998; 179 (04) 938-941
    CrossrefPubMedGoogle Scholar
  • 13 Juhasz G, Gyamfi C, Gyamfi P, Tocce K, Stone JL. Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery. Obstet Gynecol 2005; 106 (04) 741-746
    CrossrefPubMedGoogle Scholar
  • 14 Kominiarek MA, Zhang J, Vanveldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labor patterns: the impact of maternal body mass index. Am J Obstet Gynecol 2011; 205 (03) 244.e1-244.e8
    CrossrefPubMedGoogle Scholar
  • 15 Zhang J, Landy HJ, Branch DW. , et al; Consortium on Safe Labor. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol 2010; 116 (06) 1281-1287
    CrossrefPubMedGoogle Scholar