Factors Associated with Successful Vaginal Birth after Lower Uterine Transverse Cesarean Section Delivery in Public Hospitals of Bahir Dar city, Northwest, Ethiopia

Abstract

Introduction: Vaginal birth after cesarean section is the term applied to a woman who undergoes vaginal delivery following cesarean section. It is the preferred method to decrease complications associated with repeated cesarean section delivery. Objectives This study aimed to assess factors associated with successful vaginal birth after lower uterine transverse cesarean section delivery and to validate the Flamm and Geiger score in the public hospitals of Bahir Dar city, Northwest, Ethiopia. Methods Health facility-based retrospective cross-sectional study was conducted from March 1–15/2021 among 345 mothers who gave birth by caesarian section from January 1/2020 to December 31/2020. The data was collected by a simple random sampling technique, entered into Epi data 3.1, and analyzed using SPSS 25.0 version. Logistic regression analyses were done to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. Results This study identified that 35.07% of the women had a successful vaginal birth after one lower uterine transverse cesarean section delivery and among them. Of the failed trial of labor, fetal distress (38.9%) and failed progress of labor (32.1%) were the main indications for emergency cesarean section. Maternal age ≤ 30 years, prior successful vaginal birth after cesarean section delivery, prior vaginal delivery before cesarean section, non-recurrent indication (fetal distress and malpresentation), ruptured membrane, cervical dilatation ≥ 4cm, cervical effacement ≥ 50%, and low station (≥ 0) at admission were associated with successful vaginal birth after one lower uterine transverse cesarean section delivery. For the Flamm and Geiger scores at a cut point of 5, the sensitivity and specificity were 73.6% and 86.6% respectively. Conclusion The successful vaginal birth after one lower uterine transverse cesarean section was low in the study area. When the total Flamm and Geiger score increases, the chance of successful vaginal birth after one lower uterine transverse cesarean section increases. We suggest emphasizing the careful selection of women for a trial of labor.