Letters

Vaginal delivery after caesarean section

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7324.1307 (Published 01 December 2001) Cite this as: BMJ 2001;323:1307

Study's focus on induction v spontaneous labour neglects spontaneous delivery

  1. Betty-Anne Daviss (midwife@istar.ca), chair
  1. Statistics and Research Committee, Midwives Alliance of North America Midwifery Collective, Ottawa, Ontario, Canada K1S 2Z7
  2. Statistics and Research Committee, Midwives Alliance of North America, Ottawa, Ontario, Canada K1S 2Z7
  3. Midwives Alliance of North America, 41 The Farm, Summertown, TN 38483, USA

    EDITOR—Josefson reports on a study by Lydon-Rochelle et al that found that induction of labour was associated with increased risk of uterine rupture.1 Although the research isolated prostaglandins from other forms of induction, it failed to isolate those women induced specifically with oxytocic drugs and those who were not induced but were given augmentation. This more specific stratification could entirely change the risk levels and clinical implications for particular groups.

    The study found that induction of labour without prostaglandins increased the relative risk significantly (to 4.9). As this cohort presumably included women who had induction by artificial rupture of the membranes, medicated forms of induction within this “other” category could pose an even higher relative risk.

    Recent studies looking at …

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