In 2015 ObGyn Dept of Santo Spirito Hospital in Pescara (Italy) started protocol for previous CS vaginal birth. In 2021 was started a protocol for training on obstetric emergencies and protocol on two previous cesarean was endorsed. Patients attending birth in Pescara with two previous from january 2016 to December 2020, and from january 2021 to december 2025 were collected. A different counseling approach was adopted from 2021. Women's acceptance of trial of labor and maternal and fetal outcomes were collected.
pregnant women
pregnancy above 34 weeks' gestation
cephalic presentation of the fetus
singleton and twins
pregnancy below 34 weeks' gestation
breech baby
triplets or high order multiple pregnancies
more than 2 previous CS
pregnant women attending birth in Santo Spirito Hospital Pescara (Italy) from 01-01-2016 to 31-12-2025
Cohort
Retrospective
Acceptance, rate of vaginal birth and safety
Procedure/SurgeryIn 2021 started a new delivery protocol enhancing the opportunity of having a trial of labor in women with a history of two previous CS. Rate of acceptance, rate of successful vaginal birth, maternal and fetal outcomes were evaluated
vaginal birth after 2 cesarean
Incidence of patients having a vaginal birth after 2 CS
accepted indication to trial of labor
incidence of women accepting indication to trial of labor
emergency CS
incidence of emergency CS
maternal outcomes
incidence of adverse maternal outcomes (PPH, blood transfusion, vaginal tears, hysterectomy)
Fetal and Neonatal adverse outcomes
Incidence of fetal/neonatal death, NICU stay, APGAR score below 7 at 5'
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