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Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth

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Abstract

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Background

When a woman has had a previous caesarean birth and requires induction of labour in a subsequent pregnancy, there are two options for her care: elective repeat caesarean or planned induction of labour. While there are risks and benefits for both elective repeat caesarean birth and planned induction of labour, current sources of information are limited to non‐randomised cohort studies. Studies designed in this way have significant potential for bias and consequently conclusions based on these results are limited in their reliability and should be interpreted with caution.

Objectives

To assess, using the best available evidence, the benefits and harms of elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1) and PubMed (1966 to January 2006).

Selection criteria

Randomised controlled trials with reported data that compared outcomes in mothers and babies who planned a repeat elective caesarean section with outcomes in women who planned induction of labour, where a previous birth had been by caesarean.

Data collection and analysis

There was no data extraction performed.

Main results

There were no randomised controlled trials identified.

Authors' conclusions

Planned elective repeat caesarean section and planned induction of labour for women with a prior caesarean birth are both associated with benefits and harms. Evidence for these care practices is drawn from non‐randomised studies, associated with potential bias. Any results and conclusions must therefore be interpreted with caution. Randomised controlled trials are required to provide the most reliable evidence regarding the benefits and harms of both planned elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Elective repeat caesarean versus planned induction of labour for women with a previous caesarean birth

When a woman has had a previous caesarean birth, and requires induction of labour in a subsequent pregnancy, there are two options for her care: elective repeat caesarean or planned induction of labour. Both forms of care have benefits and risks associated with them. There were no trials to help women, their partners and their caregivers make this choice.