Vaginal birth after two previous cesareans before and after new training and protocols
Official title: Trial of Labor After Two CS Before and After Training a Protocol Introduction
Run by G. d'Annunzio University · NCT07258459 · Data updated 2026-11-12
See if introducing new staff training and counseling protocols increased acceptance of trial of labor and the rate of vaginal birth among pregnant women with two prior cesarean deliveries.
Quick facts
| Study type | Observational |
|---|---|
| Ages | 18 Years and up |
| Sex | Women only |
| Enrollment | 2016 (estimated) |
| Sponsor | G. d'Annunzio University Academic / other |
| Locations | 2 sites (Pescara, PE and 1 other locations) |
| Status | Recruiting |
| Started | January 1, 2016 |
| Main results expected | December 31, 2025 |
| Study ends | January 1, 2026 |
| Registry record updated | December 2, 2025 |
| Trial ID | NCT07258459 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Pregnant women with two prior cesarean sections, at least 18 months since the last cesarean, gestational age ≥34 weeks, cephalic presentation, and no other indication for cesarean (including singleton or diamniotic twins).
✕Probably not a fit
Women with clinical indications for cesarean such as placenta previa, less than 18 months since the last cesarean, breech or triplet presentations, or other contraindications are unlikely to benefit from trial of labor approaches studied here.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This observational comparison collected women with two prior cesarean sections who delivered at Santo Spirito Hospital in Pescara before (2016–2020) and after (2021–2025) implementation of obstetric emergency training and a specific counseling protocol. Investigators recorded acceptance of trial of labor, vaginal birth rates, and maternal and neonatal adverse outcomes such as postpartum hemorrhage, transfusion, hysterectomy, fetal death, NICU admission, and low 5-minute Apgar. Eligible participants were ≥34 weeks' gestation with cephalic presentation and at least 18 months since the last cesarean, including singleton or diamniotic twin pregnancies, while cases with other indications for cesarean, breech, triplets, or gestation <34 weeks were excluded. The analysis compares acceptance and safety outcomes before and after the training and protocol change to see if counseling and staff preparation altered clinical practice and results.
Why it matters
Potential benefit: If successful, the protocols could increase safe vaginal births and reduce repeat cesarean deliveries for women with two prior cesareans.
How similar studies have gone: Prior studies show trial of labor after cesarean (TOLAC) can be safe for selected patients, but evidence specifically addressing women with two prior cesareans is limited and has mixed results.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * pregnant women * pregnancy above 34 weeks' gestation * cephalic presentation of the fetus * singleton and twins * diamniotic twins * 2 previous CS * more than 18 months from last CS * no other indication to CS Exclusion Criteria: * pregnancy below 34 weeks' gestation * breech baby * triplets or high order multiple pregnancies * more than 2 previous CS * less than 18 months from last CS * precence of other indications to CS (i.e. maternal diseases, placenta previa, etc.)
Where it's running
-
Claudio Celentano
Pescara, Pe, Italy Recruiting -
Santo Spirito Hospital
Pescara, Pe, Italy Recruiting
Study contacts
- Study coordinator: Claudio Celentano, MD
- Email: celentanoclaudio70@gmail.com
- Phone: +39 328 5577305
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
-
Predicting Birth Type and Breastfeeding Success from Physical Fitness and Emotions in Late Pregnancy
Researchers are testing whether simple grip strength and chair stand tests, plus feelings about childbirth, can help predict delivery type and six-month breastfeeding success for women in their late pregnancy.
-
Scheduled peanut birthing-ball positioning for labor in first-time mothers with an epidural
We will try scheduled position changes using a peanut birthing ball to see if it shortens the first and second stages of labor and improves delivery outcomes for first-time mothers who have an epidural.
-
Testing a new guide for monitoring labor and childbirth in Norway
This study is testing a new guide for monitoring labor and childbirth to see if it can improve care and reduce unnecessary interventions for mothers and babies in Norway.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.