White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor

Clint M. Cormier, Mark B. Landon, Yinglei Lai, Catherine Y. Spong, Dwight J. Rouse, Kenneth J. Leveno, Michael W. Varner, Hyagriv N. Simhan, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan M. Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Brian M. Mercer

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Objective: To estimate the rate of vaginal birth after cesarean delivery (VBAC) success in diabetic women based on White's Classification. Methods: This is a secondary analysis of an observational study conducted at 19 medical centers of women attempting VBAC. Diabetic women with singleton gestations, one prior cesarean delivery, and cephalic presentation who underwent a trial of labor were included. Vaginal birth after cesarean delivery success rates and maternal and neonatal complications were compared based on White's Classification. Results: Of 11,856 women who underwent trial of labor, 624 met all study criteria (class A1, 356; A2, 169; B, 70; C, 21; D/R/F, 8). Vaginal birth after cesarean delivery success in each group was: A1, 68.5% (95% confidence interval [CI] 63.4-73.3%); A2, 55% (95% CI 47.2-62.7%); B, 70% (95% CI 57.9-80.4%); C, 47.6% (95% CI 25.7-70.2%); and D/F/R, 12.5% (95% CI 0.3-52.7%). Maternal and neonatal complications were rare and not found to be different among groups. CONCLUSION: Our study provides estimates for VBAC success based on White's classification and indicates a relatively low rate of perinatal complications after VBAC attempt for diabetic women.

Original languageEnglish (US)
Pages (from-to)60-64
Number of pages5
JournalObstetrics and gynecology
Volume115
Issue number1
DOIs
StatePublished - Jan 2010

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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