{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:37:38Z","timestamp":1788514658580,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","award":["00200306"],"award-info":[{"award-number":["00200306"]}],"id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the impact of uterine contractile activity on the outcome of trial of labour after caesarean section (TOLAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary, blinded analyses of a prospective TOLAC cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two labour wards, one in a university tertiary hospital and the other in a central hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 194 TOLAC parturients with intrauterine tocodynamometry during labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of intrauterine pressure, frequency of contractions and baseline tonus of uterine muscle in 30\u2010minute periods for 4\u2009hours before birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Primary outcome: uterine contractile activity during TOLAC. Secondary aims: contributors associated with failed TOLAC and uterine rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TOLAC succeeded in 74% of cases. Uterine contractile activity, expressed as intrauterine pressure, was significantly higher in successful TOLAC compared with failed TOLAC (210 versus 170\u2009Montevideo units). The statistically significant risk factors of failed TOLAC, after multivariate regression analysis, were prolonged gestational age, reduced cervical dilatation at admission and lower mean intrauterine pressure. In cases of uterine rupture, contractile activity did not differ from that in failed TOLAC. Cervical ripening with a Foley catheter appeared to be a risk factor for uterine rupture, as well as cervical dilatation &lt;3\u2009cm at admission. The incidence of total uterine rupture was 2.6% (<jats:italic>n<\/jats:italic>\u2009=\u20095).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with successful vaginal birth had higher uterine contractile activity than those experiencing failed TOLAC or uterine rupture despite similar use of oxytocin. Induction of labour with a Foley catheter turned out to be a risk factor for uterine rupture during TOLAC among parturients with no previous vaginal delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>During VBAC the response to oxytocin, assessed as intrauterine pressure, is greater and adequate, in contrast to failed TOLAC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17005","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T03:29:21Z","timestamp":1636774161000},"page":"976-984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["How does uterine contractile activity affect the success of trial of labour after caesarean section, and the risk of uterine rupture? An exploratory, blinded analysis of a cohort from a randomised controlled trial"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5124-6735","authenticated-orcid":false,"given":"TM","family":"Hautakangas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Central Finland Health Care District  Jyv\u00e4skyl\u00e4 Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JT","family":"Uotila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Tampere University Hospital and Faculty of Medicine and Health Technology Tampere University  Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HSA","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"OL","family":"Palom\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Tampere University Hospital and Faculty of Medicine and Health Technology Tampere University  Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-020-00983-y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15271"},{"key":"e_1_2_7_4_1","first-page":"110","article-title":"Clinical management guidelines for obstetrician \u2013 gynecologists: vaginal birth after cesarean delivery","volume":"133","author":"ACOG","year":"2019","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1991.tb13391.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00336.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12508"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-828608"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31930-5"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.487893"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609053351001"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2010.03.006"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200207000-00004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.obstetgynecol.2003.10.011"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-016-4214-7"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90375-X"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1992.tb01948.x"},{"key":"e_1_2_7_18_1","first-page":"470","article-title":"Association of Montevideo units with uterine rupture in women undergoing a trial of labor","volume":"59","author":"Maggio L","year":"2014","journal-title":"J Reprod Med"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1989.tb03349.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1989.tb03348.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16343"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-1938-3"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2334-3"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.05.066"},{"key":"e_1_2_7_25_1","first-page":"373","article-title":"Changes in fetal heart rate and uterine patterns associated with uterine rupture","volume":"49","author":"Sheiner E","year":"2004","journal-title":"J Reprod Med Obstet Gynecol"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040405"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109148.23082.C1"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.50"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.001"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/517461"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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