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

Abstract

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 benets 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 signicant 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 benets and harms of elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth. Search strategy: 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 identied. Authors' conclusions: Planned elective repeat caesarean section and planned induction of labour for women with a prior caesarean birth are both associated with benets 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 benets and harms of both planned elective repeat caesarean section and planned induction of labour for women with a previous caesarean birth. Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.