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Other Comments:
Very interesting paper documenting a novelty in the field thus quiet right to be published.
It may however be difficult to translate in to everyday practice because of the inherent attendant morbidity and possible mortality. Hence , I must sound a note of caution! It may not always end successfully like this! Therefore, instead of selecting patients to allow a trial of vaginal delivery after 3 previous caesareans, we should aim at outrightly reducing the number of primary caesarean deliveries.
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Competing interests:
None.
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Invited by the author to review this article? :
Yes -
Have you previously published on this or a similar topic?:
Yes
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References:
Uzoigwe SA, Ogu R. Unplanned Vaginal birth after 2 previous caesarean sections. The case of an unbooked patient. Nig Med Pract 2005; 48(2) 43-44 -
Experience and credentials in the specific area of science:
As a practising obstetrician, I have seen cases of successful vaginal birth after 2 previous caesarean deliveries! This is despite the fact that Elective repeat caesarean delivery is the standard of care for 2 previous caesarean delivery. Thus it is somewhat acceptable to allow vaginal delivery when patients with 2 previous caesareans present in advanced labour and with no other contraindication for vaginal delivery.
Vaginal birth after 3 caesareans is a novelty which this paper presents and thus it merits publication! However! a note of caution as rightly sounded by the authors must be reemphasizes!!! Vaginal delivery MAY be possible after 3 previous caesareans! Not IS encouraged! And only in carefully selected patients!
- How to cite: Ogu R N.Caution even though Vaginal birth after 3 previous caesarean delivery is possible.[Review of the article 'Vaginal Birth After Three Previous Caesarean Sections: A Case Report ' by Anyanwuocha K].WebmedCentral 2011;1(11):WMCRW00180
The fact that the woman was in labour for 12 hours, prolonged labour,
should have been discussed in the article.
Litigation cannot be foreclosed should complications arise since it isn’t a standard practice yet and it is very unlikely there will ever be a randomized control trial on mode of delivery after 3 previous caesarean sections.
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Very good experience