Prognostic factors for successful vaginal birth after cesarean section — Analysis of 162 cases

• Published in: Journal of obstetrics and gynaecology of India Vol. 60; no. 6; pp. 498 - 502
• Main Authors: Doshi, Haresh U., Jain, Rohit K., Vazirani, Aarti A.
• Format: Journal Article
• Language: English
• Published: India Springer-Verlag 01-12-2010
• Subjects: Gynecology; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Original; Original Article; Obstet Gynecol; Fetal Distress; Caesarean Section; Vaginal Delivery; Uterine Rupture
• ISSN: 0971-9202; 0975-6434
• DOI: 10.1007/s13224-010-0056-6

Objective
To analyze the success rate of VBAC (Vaginal birth after cesarean section) with reference to various factors and derive simple and easily usable prognostic factors to predict successful VBAC.
Methods (Study Design)
In this retrospective observational study, 162 women who had undergone successful trial of labor were analyzed to study the factors which contributed to successful trial of labor over a study period of one year. Maternal age, prior antenatal visits, prior obstetric history, neonatal weight and interconceptional period were studied with reference to outcome of VBAC. Success of VBAC when compared with prior indication for CS was studied. The role of instrumental deliveries for VBAC was analyzed. Maternal and perinatal mortality and morbidity were assessed. Chi square test was used to analyze the significance of each factor.
Results
Success rate of VBAC was 75%. Maternal age, prior antenatal care, prior vaginal delivery, neonatal weight and interconceptional period were all statistically significant predictors (P<0.001) of successful VBAC. Instrumental deliveries were helpful in successful VBAC and can be used prophylactically to cut short second stage. VBAC had no adverse maternal or perinatal outcome.
Conclusion
VBAC can be successfully tried in all women with prior cesarean section by careful selection and employing simple predictive factors.