Vaginal birth after cesarean: a comparison of maternal and neonatal morbidity to elective repeat cesarean section.

Abstract

A retrospective study of vaginal birth after cesarean (VBAC) was conducted over 24 months. Of 152 women who had a previous cesarean, 141 were offered VBAC. Sixty-eight had an elective repeat cesarean, and 73 agreed to VBAC. These groups were similar with respect to age, race, parity, and weight. Fifty-nine of the VBAC patients delivered vaginally (80.8%). The two groups were compared for the incidence of febrile morbidity, endomyometritis, uterine dehiscence and estimated blood loss at delivery. There were no significant differences between the two groups or when each was compared with a control group of 69 routine vaginal deliveries except for the estimated blood loss and the number of days hospitalized (p less than 0.05). Neonatal morbidity was examined between the two groups by comparing the incidence of transient tachypnea and the number of newborns with suspected sepsis, as well as those requiring antibiotics or admission to the Neonatal Intensive Care Unit. The repeat cesarean group had a higher overall incidence of neonatal morbidity than the VBAC group, but this was not statistically significant. However, there was statistical significance (p less than 0.05) when comparing the number of days hospitalized between the infants in the VBAC group versus the repeat cesarean group. This study supports VBAC as a safe alternative to elective repeat cesarean for the patient and neonate. Data analysis was performed using Student's t test or chi-square analysis with a p less than 0.05 regarded as being statistically significant.