Attempted Vaginal Delivery After a Cesarean Section Clinical Trial
Official title:
A Specific Cervicograph for Women Attempting at Vaginal Delivery After Cesarean Section: is the Management of Labor Improved?
The main objective is to evaluate a specific cervicograph (the graph describing the cervical dilation, included in the partograph) for pregnant women with an history of cesarean section, to improve the management of labor for women attempting at a vaginal delivery (VBAC). Women will be randomly assigned to this specific cervicograph (including an action line 2 hours after the alert line), or to the normal cervicograph (no lines). The primary outcome is appropriate detection of dystocia.
Appropriate management of labor is essential to minimize the risk of uterine rupture in case
of attempt at vaginal delivery after a cesarean section (VBAC). Dystocia is a known risk
factor for uterine rupture during labor in women with previous cesarean section. Some studies
have shown that this risk increases after 2 hours at the same cervical dilation during labor.
The cervicograph is an important tool to detect dystocia during labor. There is currently no
specific cervicograph for pregnant women with a history of cesarean section, and no study
evaluated the cervicograph in the monitoring of labor for women with a scarred uterus.
The main objective is to evaluate a specific cervicograph (the graph describing the cervical
dilation, included in the partograph) for pregnant women with an history of cesarean section,
to improve the management of labor for women attempting at a vaginal delivery (VBAC). Women
will be randomly assigned to a specific cervicograph (including an action line 2 hours after
the alert line), or to the normal cervicograph (no lines).
The outcomes of this randomized trial are: appropriate detection and management of dystocia;
uterine rupture; and success of VBAC.
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