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February 2, 2026Acta Obstetricia Et Gynecologica ScandinavicaOpen Access

Nine years' experience of trial of labor after two previous cesarean sections at a tertiary hospital – A retrospective cohort study

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Authors

KLK. LeeBSBinny Priya SesurajanHRHarshaana Ramlal

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Overview

Retrospective cohort study shows safe outcomes for women undergoing TOLAC-2, indicating viable delivery options.

Key Points

  • To examine maternal and neonatal outcomes in women undergoing TOLAC-2 after two cesarean sections.
  • Retrospective observational study
  • Included women with singleton, term pregnancies in cephalic presentation
  • Conducted at National University Hospital, Singapore from 2013 to 2022
  • Data collected via electronic medical records
  • 63 out of 898 women attempted TOLAC-2, achieving a 55.6% rate of successful vaginal birth (VBAC-2)
  • Successful TOLAC-2 associated with shorter active labor (5.0 vs. 7.7 hours) and lower estimated blood loss (242 mL vs. 423 mL)
  • No serious perinatal complications reported, including uterine rupture or low APGAR scores
  • Trend observed toward higher success in VBAC-2 among women with prior vaginal birth (74.6% vs. 48.9%)

Cite This Study

Lee et al. (2026) studied this question.

synapsesocial.com/papers/6980fcfcc1c9540dea80ebd5https://doi.org/10.1111/aogs.70092
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Also Consider

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

  1. 1Maternal and perinatal outcome in trial of labour after caesarean at tertiary care hospital: a prospective observational study2020 · 1 citations
  2. 2Maternal and neonatal outcomes following trial of labor after two previous cesareans: a retrospective cohort study.2020 · 1 citations
  3. 3Trial of Labor After Cesarean and Vaginal Birth After Cesarean: A Systematic Review and Meta-Analysis of Maternal and Neonatal Outcomes2026
  4. 4Maternal and neonatal outcomes in women undergoing trial of labor after cesarean (TOLAC) compared with elective repeat cesarean section (ERCS): a cohort study2025
  5. 5Outcomes and Risk Factors for Failed Trial of Labor After Cesarean Delivery (TOLAC) in Women with One Previous Cesarean Section: A Chinese Population-Based Study2021