Is the trial of labor after cesarean in obese patients associated with adverse maternal outcomes?

A recent study that compared trial of labor after cesarean section (TOLAC) with planned repeat low transverse cesarean section (RLTCS) in a cohort of 794,278 obese patients with a history of cesarean birth observed-

• 126,809 underwent a TOLAC
• 667,469 had a planned RLTCS
• Significantly higher composite maternal adverse outcomes (CMAO) for patients undergoing TOLAC compared to RLTCS.

Hence, in obese patients with prior cesarean birth, a trial of labor may increase maternal morbidity.

Jude G, Fain A, Raker C. et al. The association between trial of labor after cesarean in obese patients and adverse maternal outcomes. Arch Gynecol Obstet. 2024; 309: 2421–2426. https://doi.org/10.1007/s00404-023-07113-6