What is the effect of an interdelivery interval of less than 18-24 months in TOLAC?

An interdelivery interval of less than 18-24 months in women undergoing a Trial of Labor After Cesarean (TOLAC) is associated with an increased risk of uterine rupture. This correlation is important because when the interval between deliveries is shorter, there may not be sufficient time for the uterine scar from the previous cesarean to heal completely and regain its structural integrity.

The uterine rupture risk is particularly critical in the context of TOLAC, as it poses significant risks both to the mother and the fetus. Shorter intervals can lead to changes in the physiology of the uterus and may lead to a greater tension on the scar during labor. Hence, it is crucial to counsel patients about the ideal interdelivery interval to optimize outcomes in subsequent pregnancies after cesarean delivery.

In contrast, longer interdelivery intervals are generally more favorable, as they allow more time for the uterus to heal, which reduces the risk of complications like uterine rupture and is more likely to contribute to successful vaginal birth after cesarean (VBAC) attempts.