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. 2024 Aug 7;14(16):1715.
doi: 10.3390/diagnostics14161715.

Risks and Probabilities of Adverse Pregnancy Outcomes in Patients Undergoing Trial of Labor after Cesarean-A Retrospective Study

Alexandru Carauleanu  1 , Iustina Solomon-Condriuc  1 , Petronela Vicoveanu  2 , Demetra Socolov  1 , Ioana-Sadiye Scripcariu  1 , Ingrid-Andrada Vasilache  1 , Iulian-Valentin Munteanu  3 , Luiza-Maria Baean  4 , Ana-Maria Adam  3 , Raluca Mogos  1 , Liliana Gheorghe  4
Affiliations

Risks and Probabilities of Adverse Pregnancy Outcomes in Patients Undergoing Trial of Labor after Cesarean-A Retrospective Study

Alexandru Carauleanu et al. Diagnostics (Basel). .

Abstract

(1) Background: Trial of labor after cesarean (TOLAC) can be associated with significant maternal and neonatal complications, and the aim of this retrospective study was to calculate the risks and probabilities of these complications in two tertiary maternity centers in Romania. (2) Methods: A total of 216 patients who attempted TOLAC were included in the study and were segregated into two groups, depending on TOLAC success. Medical records were assessed, and clinical data were used to determine the maternal and neonatal risks and complications, using multinomial logistic regression and postestimation predictions. (3) Results: Our data indicated that patients who had a failed TOLAC had significantly higher risks and probabilities of uterine rupture, either complete or incomplete; intensive care unit (ICU) admission; and emergency hysterectomy. The newborns of these mothers had significantly higher risks and probabilities of low Apgar score at birth, neonatal intensive care unit (NICU) admission, and invasive ventilation. (4) Conclusions: Failed TOLAC could lead to significant maternal and neonatal complications, and women who attempt this procedure should be monitored in a tertiary center where a multidisciplinary team and an emergency operating room are available.

Keywords: perinatal complications; perinatal risk; prediction; trial of labor after cesarean.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Scatterplot indicating the probabilities of uterine rupture in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; CI—confidence interval.
Figure 2
Figure 2
Scatterplot indicating the probabilities of maternal ICU admission in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; ICU—intensive care unit; CI—confidence interval.
Figure 3
Figure 3
Scatterplot indicating the probabilities of emergency hysterectomy in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; CI—confidence interval.
Figure 4
Figure 4
Scatterplot indicating the probabilities of a low Apgar score at birth in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; CI—confidence interval.
Figure 5
Figure 5
Scatterplot indicating the probabilities of NICU admission in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; NICU—neonatal intensive care unit; CI—confidence interval.
Figure 6
Figure 6
Scatterplot indicating the probabilities for the need of invasive ventilation in cases of failed or successful TOLAC. Legend: TOLAC—trial of labor after cesarean; CI—confidence interval.
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