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Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery


Ramirez, Mildred M.; Gilbert, Sharon A.; Landon, Mark B.; Rouse, Dwight J.; Spong, Catherine Y.; Varner, Michael W.; Caritis, Steve N.; Wapner, Ronald J.; Sorokin, Yoram; & Miodovnik, Menachem, et al. (2010). Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery. American Journal of Perinatology, 27(10), 825-830. PMCID: PMC3272299


We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD >/=20 weeks' gestation or 500 g were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age +/- standard deviation at delivery was 31.3 +/- 6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Perinatology


Ramirez, Mildred M.
Gilbert, Sharon A.
Landon, Mark B.
Rouse, Dwight J.
Spong, Catherine Y.
Varner, Michael W.
Caritis, Steve N.
Wapner, Ronald J.
Sorokin, Yoram
Miodovnik, Menachem
Carpenter, Marshall W.
Peaceman, Alan M.
O'Sullivan, Mary Jo
Sibai, Baha M.
Langer, Oded
Thorp, John M., Jr.
Mercer, Brian M., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network