Interpretation
When considering TOLAC, one should assess the risk for possible
complications, even more so, when the fetus is estimated LGA. Most
complications occur when TOLAC fails and emergent CD is needed (8, 9,
16). Thus, successful TOLAC is associated with less maternal morbidity
than elective repeat CD, whereas failed attempt is associated with a
higher risk for maternal morbidity (17). To the best of our knowledge,
to date, no study has focused on complications as a result of TOLAC for
estimated LGA fetuses. With regard to macrosomic fetuses (weights
greater than 4000 g), studies are inconsistent with whether it is
associated with increased risk for uterine rupture or not (18, 19). Our
study revealed no difference amongst women in the study and control
group, in scar dehiscence or uterine rupture rate as well as in the rate
of 3rd /4th degree perineal tear, shoulder dystocia, and need for blood
transfusion.