Study on Vaginal Birth After Two Previous Cesarean Sections Before and After New Training and Protocol Introduction

What this Trial Is About

This research focuses on women who have previously had two cesarean sections and are attending birth at Santo Spirito Hospital. It compares outcomes before and after introducing a new training and protocol starting in 2021 aimed at encouraging trial of labor after cesarean TOLAC. The study collects data on womens acceptance of TOLAC and maternal and fetal outcomes to understand the effects of the new approach. The study includes two time periods from January 2016 to December 2020, and from January 2021 to December 2025. Starting in 2021, a new delivery protocol was implemented to enhance opportunities for trial of labor in women with two previous cesarean sections. Researchers evaluate acceptance rates, vaginal birth rates, and safety outcomes for both mothers and babies during these periods. Participants are pregnant women with two previous cesarean sections, carrying single or diamniotic twins in cephalic presentation and above 34 weeks of gestation. During the study, maternal outcomes such as postpartum hemorrhage, blood transfusion, vaginal tears, hysterectomy, and maternal death are monitored alongside fetal outcomes including fetal death, neonatal intensive care unit stays, and low APGAR scores at 5 minutes. Researchers compare these outcomes between the two periods to assess the impact of the new protocol.

Two Previous Cesarean and Vaginal Birth Before and After Starting Training and Protocols