Conclusions
We conclude that trial of labor after Cesarean delivery in women with
singleton pregnancy at term with the presence of estimated large fetus
for gestational age and a prior low transverse uterine incision, is a
safe option, taking into consideration slightly lower success rate and a
higher incidence of post-partum hemorrhage.
This information should be of value to physicians and patients alike.
Assessment of fetal weight prior to counseling patients regarding TOLAC
may be of value. Further larger randomized prospective investigation
needs to be done to strengthen our findings.