Maternal and obstetrical factors associated with a successful trial of vaginal birth after cesarean section

Abdelazim, Ibrahim A.; Elbiaa, Assem A. M.; Al-Kadi, Mohamed; Yehia, Ahmed; Faza, Mohannad Abu

doi:10.5152/jtgga.2014.14104

Cited by 28 publications

(37 citation statements)

References 19 publications

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“…Abdelazim IA et al recorded that mean gestational age was significantly lower in the successful TOLAC (trial of labor after caesarean section) group compared to the unsuccessful group (37±0.04 versus 38.5±0.03). 8 In the present study authors also found that VBAC was successful at gestational age of 37-38 weeks compared to ≥39weeks ( Table 2). An inter-delivery interval of ≤24 months was associated with scar dehiscence which was more compared with inter-delivery interval of>24 months (4/22,18.18% versus 8/255, 3.13%, p=0.005) in the present study.…”

Section: Discussionsupporting

confidence: 73%

“…Per vaginal check for scar integrity done after successful vaginal delivery and symptomatic dehiscence was nil. The number of women with an interdelivery interval <2 years was significantly higher in the unsuccessful TOLAC group compared to successful group, as mentioned by Abdelazim IA et al 8 RCOG Recommended, Green-top guideline no.45 October 2015 states that women delivering within 18 to 24 months of a caesarean section should be counselled about an increased risk of uterine rupture in labour. 4 Upper segment uterine scar, improper apposition with tight uterine margin suturing, infection, poor nutritional status and short inter delivery interval are the factors for poor healing of uterine scar.…”

Section: Discussionmentioning

confidence: 91%

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Vaginal delivery at term with previous one cesarean section: is it safe?

Bera¹,

Sharma²

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Post cesarean pregnancies are high risk pregnancy and main concern is uterine scar rupture with increasing maternal and perinatal risks, for vaginal birth after cesarean delivery (VBAC). Objective of this study is to know neonatal and maternal outcome at term who attempt vaginal delivery with previous one cesarean section presenting in active stage of labor.Methods: A total of 277 pregnant women with single live fetus at term, cephalic presentation with previous one cesarean section, underwent a trial of labor and outcome of successful and failed vaginal birth were noted.Results: Trial of labor was successful in 52.3% and failed in 47.7% (p=0.269). VBAC was successful where the previous cesarean section indications were fetal distress (79% versus 21%, p=0.000), pregnancy induced hypertension (77.3% versus 22.7%, p=0.000) and fetal growth restriction (81.8% versus 18.2%, p=0.000), when compared with failed trial of labor who required emergency cesarean section in pre-labor rupture of the membranes (8.3% versus 91.7%, p=0.000) and dystocia (3.3% versus 96.7%, p=0.000). VBAC was successful at gestational age of 37 0/7-38 6/7 weeks (p=0.000). In the failed VBAC women who required emergency cesarean section there was significant early neonatal death (p=0.025). Scar dehiscence and hospital stay with or without complications were more in the failed VBAC group.Conclusions: Early neonatal death and duration of hospital stay were significantly more in the failed VBAC, who were posted for emergency cesarean delivery. Scar dehiscence occurred in the failed VBAC group. Women presenting at 37 0/7 to 38 6/7 weeks of gestation with cephalic presentation in active stage of labor who had previous cesarean section done for fetal distress, pregnancy induced hypertension and fetal growth restriction with inter pregnancy interval of > 24 months can be planned and counselled for VBAC trial of labor.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 91%

Vaginal delivery at term with previous one cesarean section: is it safe?

Bera¹,

Sharma²

2018

Int J Reprod Contracept Obstet Gynecol

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“…Regarding the admission variables, the majority of pregnant women admitted with dilation equal or less than three centimeters were submitted to C-section. Studies that linked cervical dilation with the type of delivery support the finding of this study (8,11,17,21) . Thus, it can be implied that early hospitalization, before the active stage of delivery, contributes to higher interventions that could lead to C-sections.…”

Section: Variablesupporting

confidence: 84%

“…The high rates of C-section among women who underwent a previous surgical delivery show this previous C-section as a significant factor for carrying out a new one (13,16) , which could reach a prevalence up to five times more (8,11,14) . In contrast, in a study (17) that included women eligible for a delivery trial after the C-section, normal birthrate was higher when compared to C-sections (72.1% and 27.8%, respectively). Therefore, it is important to emphasize the possibility of carrying out a vaginal delivery in women with previous a C-section, since studies have shown successful outcomes in this situation.…”

Section: Variablementioning

confidence: 73%

Fatores associados a cesáreas em um hospital universitário de alta complexidade do sul do Brasil

Saraiva¹,

Gouveia

Gonçalves

2018

Rev. Gaúcha Enferm.

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Objective To identify the factors associated with cesarean sections in a high complexity university hospital in southern Brazil. Methods Cross-sectional study carried out at the Obstetric Hospital Unit of the Hospital de Clínicas de Porto Alegre. Data were gathered from questionnaires carried out with 361 puerperal women and maternal and neonatal records, from February to April 2013. For the analysis, Prevalence Ratio through Univariate Poisson Regression was used. Results The prevalence of cesarean sections was 31%. The category of hospitalization, cervix dilation and its characteristics, fetal presentation, and uterine dynamics, at the time of admission, were statistically related to cesarean sections; not having a previous cesarean section and night shift (from midnight to 6AM) were protective factors. Conclusions The prevalence of cesarean sections is above the rate recommended by the World Health Organization, but it is similar to rates found in other university hospitals, thus pointing out the need for the proposition of actions aimed at improving this indicator.

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“…The VBAC success rates in other studies ranged from 59%-91% with most of them reporting a rate of 60% -80%. 6,[14][15][16][17][18][19][20] In the present study we found that women with history of previous vaginal delivery had a higher success rate of VBAC (84.8%) compared to women who did not have one. This is compared with other studies as shown in Table 4 However in the above studies while interpreting the VBAC success rates for women with history of previous vaginal delivery, the success rate of women with history of prior VBAC and history of vaginal delivery before LSCS has not been evaluated separately.…”

Section: Discussionmentioning

confidence: 79%