Neonatal outcomes of patients with vaginal delivery after a Caesarean section

Abstract

Purpose: The rates of caesarean section (CS) have been increasing in recent years in Türkiye and throughout the world. A previous CS is known to not be an absolute indication for repeat CS, and vaginal delivery (VD) (trial of labor after caesarean (TOLAC)) can occur after a CS. The aim of this study was to investigate the neonatal outcomes of TOLAC patients in Konya City Hospital.
 Materials and Methods: A retrospective analysis was made of the records of all the births in Konya City Hospital between 10 August 2020 and 10 June 2022. The study included all patients with full or nearly complete cervical dilation-effacement and who had a previous CS. These patients were compared with patients who had elective CS and VD. A total of 119 patients were included in the study in 3 groups; TOLAC n:32, CS n:42, VD n:45.
 Results: TOLAC patients gave birth earlier and the infant birth weight (2991.25gr), length (50.66cm) and head circumference (34.09cm) measurements were found to be significantly lower than those of the other groups. The development of any problem (icterus, respiratory distress syndrome (RDS), oxygen requirement, hypoglycemia, hypothermia) was determined at a significantly higher rate in the TOLAC (21.9%).
 Conclusion: Patients with a history of CS do not have to have a repeat CS. TOLAC can be performed in appropriate cases, but care should be taken against uterine rupture, the need for emergency CS, and adverse neonatal outcomes.