Study asseses risk of serious complications for vaginal birth after C-section

Friday, February 6th 2004, 12:00 am

By: News On 6

COLUMBUS, Ohio (AP) _ Mothers have a less than 1 percent chance of having a uterine rupture if they deliver vaginally after a previous Caesarean section, according to a study released Thursday.

The study's findings will help women make better informed decisions about childbirth, said Dr. Mark Landon of Ohio State University Medical Center, who led the study.

``We have put a number on a risk that clinicians understood existed for some time, but had difficulty counseling women of the level of these risks,'' he said.

In the U.S., about a quarter of all births are by C-section. Doctors used to recommend repeat C-sections because of the possibility that labor and a vaginal birth could rupture the scars and uterus. But in the 1990s, government experts concluded that many women could safely deliver vaginally.

The rate of vaginal births after C-sections increased from 3 percent in 1981 to about 31 percent in 1998, said Landon, who presented the study Thursday at a meeting of the Society of Maternal Fetal Medicine in New Orleans.

The government-funded study of 46,000 women was conducted at 19 medical centers nationwide.

The researchers found that of the 17,902 women who delivered vaginally after a C-section, less then 1 percent, or 128 women, had a uterine rupture, a serious complication.

Their infants were also more likely to suffer a brain injury from lack of oxygen during delivery. There were 13 cases of brain injury _ eight occurring after uterine rupture _ and two of the babies died. There were no cases of brain injury involving the women who had repeat C-sections.

Dr. Bruce Flamm of the University of California-Irvine said the findings may lead more women to choose repeat C-sections, but that may not be the best choice.

``If you somewhat improve the outcome for the baby but make the outcome worse for the mom, then it's not so good as you thought, or vice versa,'' Flamm said.

Complications from C-sections include risk of injuring a woman's bowels or bladder, blood clots, blood loss or infection.

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