Outcome of Vaginal Birth after Caesarean Section at a Tertiary Health Facility, Southern Nigeria

Abstract

Background: Caesarean section rate has been on the increase in the past few years. Previous caesarean sections are a major indication for caesarean sections. The risks associated with repeat caesarean sections have brought about the need to adopt vaginal birth after caesarean section (VBAC) as the preferred mode of delivery in a previously scarred uterus. Aims and Objectives: To determine the pregnancy outcome and complications of vaginal birth after caesarean section at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a retrospective descriptive study of 121 women with one previous caesarean section who presented at the labour ward of the University of Port Harcourt Teaching Hospital between January 1, 2010, and December 31, 2019. Data was obtained from the case notes, ward, and theatre registers, encoded into a spreadsheet, and analyzed using SPSS 22.0. The results are presented as means, rates and proportions. Associations between variables were assessed using students t-test and Pearson’s correlation. Statistical significance was considered at P<0.05. Results: There were 20,661 deliveries during the period under review. Of these, 175 had vaginal birth after caesarean section (VBAC). However, only 121 case notes were available for analysis. About one third, 44 (36.36%) of the women had previous successful VBAC and 5 (4.13%) had augmentation of labour. Perineal laceration was the most common complication 38 (31.4%). Majority of the babies 103 (85%) had APGAR scores > 7 in the first minute, while 10 (8.55%) were admitted in the Special Care Baby Unit. Maternal age, socioeconomic status, gestational age at delivery and birth weight were not significantly associated with the outcome of VBAC. Conclusion: Vaginal Birth after Caesarean Section is safe and should be recommended in carefully selected women with previous caesarean section, to reduce the morbidities associated with repeat caesarean sections.