Adi Weintraub

Objective: To investigate whether vacuum extraction due to failure of labor to progress (dystocia) during the second stage in a delivery following a previous cesarean section (CS) is related to increased adverse maternal and perinatal outcomes as compared with repeated CS. Study design: A retrospective cohort study of pregnancy and delivery outcomes of patients in their second deliveries attempting a vaginal birth after cesarean (VBAC) following one CS was conducted. Patients who delivered by vacuum extraction were compared with patients who underwent a repeated CS for failure of labor to progress during the second stage. Results: During the study period, 319 patients with a previous CS suffered from a prolonged second stage of labor in their second delivery. Of these, 184 underwent vacuum extraction and 135 patients underwent a repeated CS. No significant differences in relevant pregnancy complications such as perineal lacerations, uterine rupture, and post-partum hemorrhage and perinatal outcomes were noted between the groups. There were no cases of perinatal mortality in our study. Conclusion: When managing second stage labor disorders, vacuum extraction does not seem to be an unsafe procedure in patients with a previous CS.