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November 17, 2025International Journal of Gynecology & ObstetricsOpen Access

Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor

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Authors

IOIrina I. OlteanVHVanessa HebertGMGiulia M. Muraca

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Overview

Scoping review reveals operative vaginal birth may reduce maternal morbidity compared to cesarean birth in TOLAC, suggesting further research is needed.

Key Points

  • To summarize evidence on maternal morbidity in operative vaginal birth versus cesarean birth during the second stage of labor for individuals with a TOLAC.
  • Conducted a scoping review of cohort studies published from 1950 to August 2023.
  • Included experimental and observational studies comparing operative vaginal birth and cesarean birth in the second stage of labor.
  • Abstracted data on participant information, procedure distribution, and maternal morbidity estimates.
  • Higher rates of surgical injuries were found in cesarean birth (10.3%) compared to operative vaginal birth (2.4%).
  • Cystotomy occurred more frequently in cesarean birth (2.5%) versus operative vaginal birth (0.5%).
  • Increased rates of composite maternal morbidity were noted with operative vaginal birth, but cesarean birth had more cases of endometritis and wound complications.

Cite This Study

Oltean et al. (2025) studied this question.

synapsesocial.com/papers/692509e8c0ce034ddc3527bfhttps://doi.org/10.1002/ijgo.70668
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor2025
  2. 2Trial of Labor After Cesarean and Vaginal Birth After Cesarean: A Systematic Review and Meta-Analysis of Maternal and Neonatal Outcomes2026
  3. 3Maternal and perinatal outcome in trial of labour after caesarean at tertiary care hospital: a prospective observational study2020 · 1 citations
  4. 4Nine years' experience of trial of labor after two previous cesarean sections at a tertiary hospital – A retrospective cohort study2026
  5. 5Maternal and neonatal outcomes of forceps delivery in women undergoing trial of labor after cesarean2026