Prospective comparison of delivery outcomes of vaginal births after cesarean section versus laparoscopic myomectomy.

摘要

Dear Editor,Makino et ah conclude that 'The present investigation confirmed that vaginal birth after LM is as safe as VBAC...', yet this study was woefully underpowered to show any such thing. The rate of uterine rupture during attempted vaginal birth after cesarean section (VBAC) during spontaneous labor is estimated to be 0.5%. Study groups of more than 1000 patients would be needed to demonstrate differences in risk (I'm sure your statistician can give a more accurate power calculation), yet this study reported just 38 attempted VBAC and 72 vaginal birth after laparo-scopic myomectomy (VBALM) with (not surprisingly) no adverse outcomes.