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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Labor

Poster Session 4

(1250) Vaginal Birth Following Second Stage Arrest Cesarean: A Worthwhile Trial?

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Cesarean (CS) in the second stage of labor may impact future reproductive health, including increasing risk of preterm birth.  We sought to assess subsequent pregnancy outcomes after second stage CS compared to CS for breech presentation. 

Study Design:
This is a retrospective cohort study of nulliparous patients undergoing a CS from 2017 to 2020 with a subsequent pregnancy at our institution. We compared outcomes in those undergoing CS for second stage arrest to those with CS for breech presentation. Baseline demographic data and delivery characteristics were abstracted. Main outcomes were mode of delivery and length of second stage in a subsequent pregnancy. Secondary outcomes included preterm birth, other delivery characteristics, and neonatal outcomes. 

Results:
180 patients with second-stage CS and 35 patients with breech CS were included. Among subsequent livebirths, those with primary CS in the second stage were less likely to have a vaginal birth after cesarean (VBAC) (22.2% vs. 39.4% p = 0.04) (Table). There was no difference in median length of the second stage in subsequent VBACs (66 vs. 77 min, p=0.26). Among those with successful VBAC, patients with prior second stage CS were more likely to present in spontaneous labor (86.5 vs 53.8%, p = 0.01); this trend was also seen among repeat cesareans but was not significant (26.2 vs. 15.0%, p=0.51). For those who underwent repeat CS, patients with a  prior second stage CS had greater estimated blood loss (median EBL 750 mL vs 600 mL, p = 0.003). There were no differences in rates of preterm birth, markers of cervical insufficiency, or neonatal outcomes between groups.

Conclusion:
We found that about 1 in 5 patients with initial CS for second stage arrest went on to have a vaginal birth. While rates of VBAC were lower in this group compared to initial CS for breech, there were higher rates of spontaneous labor and no difference in second stage length.