Women with a Preterm Cesarean Have High Rates of Successful Trial of Labor in a Subsequent Term Pregnancy

Anna L. Rietveld*, Lotte A. P. H. Heestermans, Brenda M. Kazemier, Pim W. Teunissen, Christianne J. M. de Groot

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective The rate of cesareans has increased worldwide. Therefore, an increasing number of women has to decide how to deliver in a subsequent pregnancy. Individualized information on risks and success chances is helpful. This study investigates the effect of a preterm cesarean on success of subsequent term trial of labor.

Study Design Ten-year Dutch cohort (2000-2009) of women with one previous cesarean and a subsequent term trial of labor. Subgroups were made based on gestational age at first cesarean delivery (25-28, 28-30, 30-32 and 32-34 weeks) and stratified based the way in which second delivery started. Rates of vaginal deliveries, maternal, and neonatal outcomes were compared with women who had a first-term cesarean (37-43 weeks).

Results Four thousand three-hundred forty-two women delivered by preterm cesarean in the first pregnancy. These women had high rates of successful trial of labor, both after spontaneous onset (86.2-96.2%) and induction (72.8-75.4%). Rates of adverse outcomes were low and similar compared with women with a previous term cesarean.

Conclusion In this 10-year nationwide cohort, women with a preterm first cesarean who opted for trial of labor in a subsequent pregnancy had high rates of successful trial of labor.

Original languageEnglish
Pages (from-to)709-714
Number of pages6
JournalAmerican Journal of Perinatology
Issue number7
Publication statusPublished - Jun 2019


  • cesarean delivery
  • trial of labor
  • vaginal birth after cesarean
  • preterm cesarean

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