TITLE:
Prediction of Success Rates of Vaginal Birth after Cesarean Delivery According to the Previous Indication for Cesarean Delivery
AUTHORS:
Hytham Atia, Amani Khider, Nagy M. Metwally
KEYWORDS:
TOLAC, VBAC, Cesarean Section Indication, Prediction of Success of Vaginal Birth after Cesarean
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.1,
January
18,
2023
ABSTRACT: Background: Trial of labor after
cesarean delivery (TOLAC) has long been accepted as a safe option for women
with previous cesarean delivery. Previous efforts have been exerted in trials
to predict the success rates of TOLAC according to specific parameters related
to previous cesarean section and before TOLAC. We
aimed to investigate the different indications of previous cesarean delivery as independent predictors for
successful vaginal birth. Methods: A retrospective study
was conducted in Armed Forces Hospitals of the Southern Region between December
15, 2019, and July 1, 2020. The included 566 patients with previous cesarean
section who were willing to undergo a trial of labor were divided into two
groups according to the success of vaginal birth (VBAC). Results: The nonrecurring
indications for previous cesarean delivery were higher in the successful group
(fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal
pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a
significantly higher percentage of previous successful VBAC (47.7% vs 21.9%)
and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical
disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%,
respectively) than the unsuccessful group. Conclusion: During counseling
regarding trial of labor after cesarean section, indications for previous
cesarean section not related to arrest of labor can predict higher success of
VBAC. Moreover, previous successful vaginal delivery or VBAC improves the
success rates.