@article{fdi:010068757,
  title = {{M}aternal and perinatal outcomes associated with a trial of labour after previous caesarean section in sub-{S}aharan countries},
  author = {{K}abor{\'e}, {C}. and {C}haillet, {N}. and {K}ouanda, {S}. and {B}ujold, {E}. and {T}raor{\'e}, {M}. and {D}umont, {A}lexandre},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective {T}o assess the risks of uterine rupture, maternal and perinatal outcomes associated with a trial of labour ({TOL}) after one previous caesarean were compared with having an elective repeated caesarean section ({ERCS}) without labour in low-resource settings. {D}esign {A} prospective 4-year observational study. {S}etting {S}enegal and {M}ali. {S}ample {A} cohort of 9712 women with one previous caesarean delivery. {M}ethods {M}aternal and perinatal outcomes were compared between 8083 women who underwent a {TOL} and 1629 women who had an {ERCS}. {P}erinatal and maternal outcomes were then stratified according to the presence or absence of risk factors associated with vaginal birth after caesarean section. {T}hese outcomes were adjusted on maternal, perinatal and institutional characteristics. {M}ain outcome measures{T}he risks of uterine rupture, maternal complication and perinatal mortality associated with {TOL} after one previous caesarean as compared with {ERCS}, {R}esults{T}he risks of hospital-based maternal complication [adjusted odds ratio ({OR}) 1.52; 95% {CI} 1.09-2.13; {P} = 0.013] and perinatal mortality (adjusted {OR} 4.53; 95% {CI} 2.30-9.92; {P} < 0.001) were significantly higher in women with a {TOL} compared with women who had an {ERCS}. {H}owever, when restricted to low-risk women, these differences were not significant (adjusted {OR} 0.90, 95% {CI} 0.55-1.46, {P} = 0.68, and adjusted {OR} 1.13; 95% {CI} 0.75-1.86; {P} = 0.53, for each outcome, respectively). {U}terine rupture occurred in 25 (0.64%) of 3885 low-risk women compared with 70 (1.66%) of 4198 women with unfavourable risk factors. {C}onclusion {L}ow-risk women have no increased risk of maternal complications or perinatal mortality compared with women with one or more unfavourable factors. {T}weetable abstract{L}ow-risk women have a lower risk of maternal complications or perinatal mortality compared with high-risk women. {T}weetable abstract {L}ow-risk women have a lower risk of maternal complications or perinatal mortality compared with high-risk women.},
  keywords = {{E}lective repeated caesarean section ; perinatal and maternal outcomes ; low-resource setting ; sub-{S}aharan {A}frica ; trial of labour ; vaginal birth after caesarean section ; {SENEGAL} ; {MALI}},
  booktitle = {},
  journal = {{BJOG} : {A}n {I}nternational {J}ournal of {O}bstetrics and {G}ynaecology},
  volume = {123},
  numero = {13},
  pages = {2147--2155},
  ISSN = {1470-0328},
  year = {2016},
  DOI = {10.1111/1471-0528.13615},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068757},
}