Success Rate Of Vaginal Birth Research Articles

Vaginal Birth after Caesarean Section: A Study of 60 Patients with Spontaneous Onset of Labor Pain

Background: Most women with a singleton pregnancy of cephalic presentation at 37+ weeks or later who have had a single prior lower segment cesarean delivery, with or without a history of prior vaginal birth, are candidates for planned VBAC and may be offered it for a trial of VBAC. Objective: The objective of this study is to determine the outcome of vaginal birth after caesarean section (VBAC) in a tertiary care hospital in Sylhet. Methods: This prospective study took place between April 2022 and February 2023 and lasted for a total of eleven months. A total of sixty patients were hospitalized in the gynecology and obstetrics department at North East Medical College, all of whom had a history of either one or two previous cesarean sections and were experiencing labor pain. 43 of these patients had their deliveries through the vaginal route. The remainder of the patients had cesarean sections because of fetal distress, scar tenderness, and the patient's wish during 1st stage of labor. Results: The VBAC success rate in this study was 71.67%. Among the 43 patients, the highest number of patients, 51.2%, came from the age range of 28-37 years, followed by 21 patients (48.8%), who were in the age category of 18-27 years. The majority of the patients (24, 55.82%) were in their second pregnancy, with 10 (23.25%) in their third pregnancy and 9 (20.93%) in their more than third pregnancy. Among the 43 patients, 42 (97.7%) had a previous caesarean section, while the remaining 1 patient (2.3%) had two previous caesarean sections. Most patients (58.14%) were admitted to the hospital between 35 and 38 weeks of pregnancy. Among the participants, 97.7% had normal placenta size, 88.4% had average bleeding, 79.1% had clear liquor and 97.7% had no scar rapture. The study shows an extremely low level of complication in VBAC. Conclusion: This study identified that, the success rate of vaginal birth after one caesarean section is very high. An evidence-based systematic review suggested that planned VBAC is a safe and appropriate mode of delivery for the majority of pregnant women with a single previous lower-segment caesarean delivery.

Factors associated with successful vaginal birth after one lower uterine transverse cesarean section delivery

A Trial of labor after cesarean section is an attempt to deliver vaginally by a woman who had a previous cesarean delivery and when achieved by a vaginal delivery it is called successful vaginal birth after cesarean section. Vaginal birth after a caesarian section is a preferred method to decrease complications associated with repeated caesarian section delivery for both mother and fetus. It has a higher success rate when the right women are selected for a trial of labor. This study aimed to assess factors associated with successful vaginal birth after one lower uterine transverse cesarean section and to validate the Flamm and Geiger score at the public hospitals of Bahir Dar City, Northwest, Ethiopia, 2021. A health facility-based retrospective cross-sectional study was conducted from March 1 to 15/2021. A medical record review of 408 women charts with a trial of labor after one lower uterine transverse cesarean section from January 1/2020 to December 31/2020 was done and 345 women charts with complete maternal and fetal information were included in the study with a response rate of 84.6%. The data were collected using a structured checklist, entered into Epi data 3.1, and analyzed using SPSS 25.0 version. Logistic regression analyses were done to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. This study identified that the trial of labor after cesarean section rate was 69.5%, and the success rate of vaginal birth after one lower uterine transverse cesarean section was 35.07%. Of the failed trial of labor, fetal distress (38.9%) and failed progress of labor (32.1%) were the main indications for an emergency cesarean section. The maternal age group of 21–30 years, prior vaginal birth after or before cesarean section, non-recurring indication (fetal distress and malpresentation), ruptured membrane, cervical dilatation ≥ 4 cm, cervical effacement ≥ 50%, and low station (≥ 0) at admission were associated with successful vaginal birth after one lower uterine transverse cesarean section. For the Flamm and Geiger score at a cut point of 5, the sensitivity and specificity were 73.6% and 86.6% respectively. In this study area, the trial of labor after cesarean section rate is encouraging, however, the success rate of vaginal birth after one lower uterine transverse caesarian section was lower. The maternal socio-demographic and obstetric-related factors were significantly associated with successful vaginal birth after one lower transverse caesarian section delivery. This study indicated that when the Flamm and Geiger score increases, the chance of successful vaginal birth after one lower uterine transverse caesarian section also increases. We suggest emphasizing counselling and encouraging the women, as their chance of successful vaginal delivery will be high in the subsequent pregnancy, especially if the indications of primary caesarian section delivery were non-recurring.

Vaginal birth after cesarean section and its associated factors in Ethiopia: a systematic review and meta-analysis

The prevalence of cesarean sections is rising rapidly and is becoming a global issue. Vaginal birth after a cesarean section is one of the safest strategies that can be used to decrease the cesarean section rate. Different fragmented primary studies were done on the success rate of vaginal birth after cesarean section and its associated factors in Ethiopia. However, the findings were controversial and inconclusive. Therefore, this meta-analysis was intended to estimate the pooled success rate of vaginal birth after cesarean section and its associated factors in Ethiopia. Pertinent studies were searched in PubMed, Google Scholar, ScienceDirect, direct open-access journals, and Ethiopian universities' institutional repositories. The data were analyzed using Stata 17. The Newcastle–Ottawa quality assessment tool was used to assess the quality of the studies. I squared statistics and Egger’s regression tests were used to assess heterogeneity and publication bias, respectively. A random effects model was selected to estimate the pooled success rate of vaginal birth after cesarean section and its associated factors. The PROSPERO registration number for this review is CRD42023413715. A total of 10 studies were included. The pooled success rate of vaginal birth after a cesarean section was found to be 48.42%. Age less than 30 years (pooled odds ratio (OR) 3.75, 95% CI 1.92, 7.33), previous history of vaginal birth (OR 3.65, 95% CI 2.64, 504), ruptured amniotic membrane at admission (OR 2.87, 95% CI 1.94, 4.26), 4 cm or more cervical dilatation at admission (OR 4, 95% CI 2.33, 6.8), a low station at admission (OR 5.07, 95% CI 2.08, 12.34), and no history of stillbirth (OR 4.93, 95% CI 1.82, 13.36) were significantly associated with successful vaginal birth after cesarean section. In conclusion, the pooled success rate of vaginal birth after a cesarean section was low in Ethiopia. Therefore, the Ministry of Health should consider those identified factors and revise the management guidelines and eligibility criteria for a trial of labor after a cesarean section.

Walking or jogging during pregnancy increases the success rate of vaginal birth after cesarean delivery: A multicenter, retrospective cohort study.

Exercise during pregnancy has been proven to reduce the risk of cesarean delivery. However, few studies have examined the relationship between walking or jogging during pregnancy and the success rate of vaginal birth after cesarean delivery (VBAC). This multicenter, retrospective cohort study aimed to determine the association between walking or jogging during pregnancy and the success rate of VBAC in women who underwent a trial of labor after cesarean delivery. The study was conducted between January 2018 and December 2019 in Foshan, China. Univariate and multivariable analyses were performed on demographic and obstetric data collected from the electronic record system. Of 1080 women included in the final analysis, 80.4% underwent VBAC. In the multivariable analysis, women who walked or jogged ≥200 min/week during pregnancy had a higher likelihood of successful VBAC than women who did not exercise, after adjusting for two sets of confounders: Model 1: Adjusted odds ratio (OR), 1.74 (95% confidence interval [CI], 1.06-2.85) and model 2: Adjusted OR, 1.83 (95% CI, 1.09-3.06). Walking or jogging ≥200 min/week during pregnancy significantly reduces the risk of cesarean delivery among women who undergo a trial of labor after cesarean delivery.

The success of vaginal birth by use of trans-labial ultrasound plus vaginal examination and vaginal examination only in pregnant women with labor induction: a comparative study

BackgroundPredicting the success of vaginal delivery is an important issue in preventing adverse maternal and neonatal outcomes. Thus, this study aimed to compare the success rate of vaginal birth by using trans-labial ultrasound and vaginal examination, and vaginal examination only in pregnant women with labor induction.MethodsThis was a comparative study including 392 eligible pregnant women with labor induction attending to a teaching hospital affiliated with Iran University of Medical Sciences from April to October 2018 in Tehran, Iran. Women were randomly assigned to two groups; the trans-labial ultrasound plus vaginal examination (group A), and the vaginal examination only (group B). Women were included in the study if they satisfied the following criteria: singleton pregnancy, 37 to 42 weeks of gestational age, fetal head presentation, a living fetus with no abnormalities, uncomplicated pregnancy, and no previous cesarean section or any uterine surgery. We used a partograph for both groups to assess the fetal head position and the fetal head station. In group 1, the Angle of Progression (AoP) and Rotation Angle (RA) were also assessed. Finally, the success and progression of vaginal delivery in two groups were compared by predicting the duration of delivery and mode of delivery.ResultsThe findings showed that 8.68% of women in the trans-labial plus vaginal examination group delivered by cesarean section, while 6.13% in the vaginal examination only group delivered by cesarean section (P = 0.55). In women with cesarean section in positive fetal head stations, Angle of Progression (AoP) was significantly decreased ranging from 90 to 135 degrees compared to women who delivered vaginally (135–180 degrees; P < 0.001). In addition, the Rotation Angle (RA) was significantly decreased in women with cesarean section ranging from 0 to 30 degrees compared to women who delivered vaginally (60-90degrees; P < 0.001). Further analysis indicated that a higher risk of cesarean section was associated with vaginal examination only as compared to trans-labial ultrasound plus vaginal examination (HR: 8.65, P < 0.001).ConclusionAngle of Progression (AoP) and Rotation Angle (RA) indexes might be useful parameters to predict labor progression and successful vaginal delivery among women undergoing labor induction.

Vaginal Birth after a Cesarean Section at Good Shepherd Mission Hospital at Tshikaji in Democratic Republic of the Congo (DRC)

Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most of obstetricians to increase the num ber of cesarean sections following a previous cesarean section. Guidelines for Vaginal birth after cesarean (VBAC) indicate that TOLAC offers women with no contraindications and one previous transverse low-segment cesarean. The objective of the current study was to study the outcome of trial of labour after caesarean section (TOLAC), the indications for emergency repeat cesarean section and to determine the maternal and fetal prognosis in vaginal birth after caesarian section (VBAC) at Tshikaji Mission Hospital. Patients, Material and Methods: This is a retrospective study of the records of 126 women were selected to undergo the TOLAC in the department of gynecology and obstetrics at the Tshikaji Mission Hospital over the period from January 1st to December 31st, 2021. The data on demography, antenatal care, labour and delivery and outcomes were collected from the maternity unit of this hospital. The data were analyzed using SPSS version 2.0. Results: The TOLAC in 126 studied women. The course of work allowed vaginal delivery 107 parturient women, a success rate of successful VBAC of 85% after the TOLAC. The repeat emergency cesarean section was necessary for delivery in 15% of cases for failed TOLAC. There was no maternal mortality, but we recorded one fetal death or 0.8% of perinatal mortality, 2 cases of cicatricial dehiscence, the incidence of 1.6%. Maternal morbidity after delivery on cicatricial uterus was dominated by postpartum hemorrhages, with 19 cases or 15.1% of cases. Cervical dilatation of more than 3 cm at the time of admission, the parity more than 3 and were the significant factors in favor of a successful VBAC. Birth weight of more than 3500 g, fetal distress and malpresentation were associated with a lower success rate of VBAC. The TOLAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. Conclusion: Pregnancy on a cicatricial uterus represents a high-risk pregnancy. Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. There is a significantly high vaginal birth after caesarian section (VBAC) success rate among selected women undergoing trial of scar in Tshikaji Hospital. TOLAC remains the option for childbirth in low resource settings as Kasai region in DRC. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remain the cornerstone to achieving high VBAC success rate.

Outcome of Vaginal Birth After Cesarean Section (VBAC)

Background: Generally, it is agreed that all women who previously had a cesarean section should be attempted for normal vaginal delivery. Of course, post-cesarean normal vaginal delivery is associated with potential risks and is sometimes clinically indicative of recurrent cesarean section. Objectives: This study aimed to evaluate the success and complications of vaginal birth after a cesarean section in pregnant women referred to Ali Ibn Abi Talib Hospital in Zahedan in 2016 - 17. Methods: The present descriptive-analytical study was carried out after the approval of the Student Ethics Committee by visiting the archive of Ali Ibn Abi Talib Hospital in Zahedan to review the hospital records of women admitted to the gynecological ward for vaginal birth after a cesarean section. The researcher abstracted data into predetermined checklists. Finally, SPSS software was used for data analysis. Results: In this study, 176 patients were evaluated. The mean gestational age was 37.64 ± 3.13 weeks. The success rate of vaginal birth after one cesarean section was 92% (162 patients), and the failure rate was 8% (14 patients). Also, the complications of vaginal birth after cesarean section were transfusion (n = 4, 2.3%), cervical rupture (n = 3, 1.7%), neonatal death (n = 4, 1.7%), and uterine rupture (n = 1, 6%) (P = 0.0). Conclusions: In the present study, the success rate of vaginal birth after one cesarean section was 92% (162 patients), and the failure rate was 8% (14 patients). Complications included blood transfusion with 2.3%, cervical rupture with 1.7%, infant mortality with 1.7%, and uterine rupture with 0.6%.

Vaginal birth after cesarean section: Experience from a regional hospital

ObjectiveTrial of labor after cesarean section (TOLAC) is an option for women with previous cesarean section. However, few women choose this option because of safety concerns. We evaluate the safety and risks associated with TOLAC and the success rate of vaginal birth after cesarean delivery (VBAC). Material and methodsWe reviewed all patients with a history of previous cesarean section that underwent elective repeat cesarean section (ERCS) or TOLAC in a regional teaching hospital from Nov, 2013 to May, 2018. Maternal basic clinical information, intrapartum management, postpartum complications, and neonatal outcomes were analyzed. Results199 pregnant women with a history of at least one previous cesarean section were enrolled. 156 women received ERCS and 43 women (21.6%) underwent TOLAC, with 37 (86.0%) who underwent successful VBAC. The VBAC rate was 18.6%. Higher success rate was found in women with previous vaginal birth than in women without vaginal birth (100% vs. 81.8%). One case (2.3%) in the VBAC group was complicated with uterine rupture and inevitable neonatal death during second stage of labor. The uterus was repaired without maternal complications. In another case, the newborn's condition was complicated with low APGAR score (<7) at birth due to maternal chorioamnionitis. Among indications for previous cesarean section, cephalo-pelvic disproportion (CPD) was associated with TOLAC failure and uterine rupture after VBAC. ConclusionVBAC is a feasible and safe option. Modes of delivery should be thoroughly discussed when considering TOLAC for women with history of previous cesarean section due to CPD, considering its association with TOLAC failure in second stage of labor.

Study of success rate of vaginal birth after cesarean section in relation to FLAMM score

Background: Globally, there is an increased trend of cesarean section (CS). Repeat CS is associated with various complications. Successful vaginal birth after caesarean section (VBAC) helps to decrease CS rate and its associated morbidities. Practice of protocol of applying FLAMM score and monitoring by partogram reduces the rate of cesarean section in the previous one lower segment cesarean section patient. Aims and Objectives: The present study is conducted to evaluate the impact of FLAMM scoring for vaginal birth after CS on obstetrics and perinatal outcome in case of the previous one lower segment CS delivery. Materials and Methods: The prospective and observational study was conducted in Obstetrics and Gynaecology department of one of the teaching institutes of Ahmedabad over a period of 1 year. Total 100 pregnant women from labour room with history of the previous one CS, who gave consent for trial of labor after the previous cesarean (TOLAC) were selected and FLAMM score applied on them. Study participants were divided in two groups according to outcome. Group A: Successful TOLAC and Group B: Failed TOLAC. Maternal and neonatal outcome was measured in both groups. Results: Out of 98 patients &lt;40 years, 74.48% had VBAC and 25% had failed TOLAC and two patients were &gt;40 years of age had VBAC. Out of 94 patients with favorable FLAMM’s score, 79% (n = 75) had VBAC and 100% (n = 6) with unfavorable FLAMM had CS. Conclusion: Careful patient selection for TOLAC is of utmost priority to increase success rate and decrease complications. FLAMM scoring system is a very efficient guiding tool for this. By applying FLAMM score, we increase success rate of TOLAC and thereby decrease CS rate in case of previous CS.

The Success Rate of Vaginal Birth after One Previous Cesarean Section in King Abdul-Aziz University Hospital

There is an alarming increase in cesarean delivery in Saudi Arabia.&nbsp;Cesarean Section can expose the mother and her fetus to some serious complications.&nbsp;Vaginal birth after cesarean section is a viable option for reducing cesarean section rates. We are aiming to estimate the prevalence, and outcome of VBAC in King Abdul-Aziz&nbsp;University&nbsp;Hospital (KAAUH) in Jeddah in 2018-2019, as well as determine the relationship between the outcome and age of the mother, gestational age, pari

Neonatal outcomes in trial of vaginal birth versus repeat caesarean delivery in preterm pregnancies: A prospective cohort study.

To characterise neonatal morbidity following preterm trial of labour (TOL) in comparison with elective repeat caesarean section (eRCS) specifically among patients without a previous vaginal delivery who may have a lower success rate of vaginal birth after caesarean. This is a secondary analysis of a multicentre prospective database. Maternal and Fetal Medicine Unit Cesarean Section Registry. Singleton pregnancies in women without a previous vaginal delivery who delivered at 24+0 weeks to 36+6 weeks gestation. Neonatal outcomes were compared between those with a TOL and those undergoing eRCS. Logistic regression was used to control for confounders, including gestational age at delivery. Composite neonatal morbidity. A total of 1906 patients were included, 985 with TOL and 921 with no TOL. The TOL success rate was 63.1%. The rate of uterine rupture was low, at 0.10% in the TOL group and 0.11% in the eRCS group (p=0.32). After adjustment, neonates born to women undergoing a TOL had no statistically significant difference in outcomes including composite neonatal outcome (adjusted odds ratio 0.86, 95% CI 0.68-1.09), neonatal intensive care unit admission, respiratory distress syndrome, necrotising enterocolitis, hypoxic ischaemic encephalopathy, seizures, transient tachypnoea of the newborn, compared with patients who underwent eRCS, with the exception of decreased risk of proven/suspected sepsis (adjusted odds ratio 0.68, 95% CI 0.52-0.87) CONCLUSION: A TOL in preterm patients without a previous vaginal delivery was not found to have a statistically significant association with increased neonatal morbidity.

Vaginal delivery after caesarean section and its associated factors in Mizan Tepi University Teaching Hospital, Southwest Ethiopia

BackgroundVaginal birth after caesarean section is appropriate for a majority of women who have had a single prior lower segment caesarean section. However, little is known about vaginal birth after caesarean section in Ethiopia. Thus, this study aimed to assess the success rate of vaginal birth after caesarean section and its associated factors in Mizan-Tepi University Teaching Hospital, southwest Ethiopia in 2020. MethodsAn institutional-based cross-sectional study was conducted among 416 mothers who gave birth by caesarean section from 2017 to 2019. The data were entered into epidata version 3.1.0 and analysed by SPSS version 21.0. Multivariable logistic regression analysis was performed to identify the factors associated with successful vaginal birth after caesarean section. A crude and adjusted odds ratio with a 95% confidence interval was used to interpret the results. A P value of <0.05 indicated statistically significant results. ResultsOf 416 completed charts reviewed, the success rate of vaginal birth after cesarean section was 170 (41%), with 95% CI (36.2%, 45.6%). The factors associated with successful vaginal birth after cesarean section were: macrosomia as past indication of cesarean section delivery: AOR; 0.31, 95% CI (0.15, 0.62); prior successful vaginal birth after cesarean section: AOR; 2, 95% CI (1.18, 3.70); previous successful spontaneous vaginal delivery: AOR; 4, 95% CI (2.05, 7.83); cervical dilatation at admission: AOR; 2.7, 95% CI (1.47, 4.95), and duration of labor: AOR; 1.7, 95% CI (1.07, 2.83). ConclusionThe success rate of vaginal birth after caesarean section in the study area was low. Macrosomia as past indication of caesarean section, prior vaginal birth after caesarean section, history of vaginal birth, cervical dilatation at admission, and duration of labour were significantly associated with the success rate. Emphasis should be placed on those factors that lead to a higher likelihood of successful vaginal birth.

Factors associated with the outcome of TOLAC after one previous caesarean section: a retrospective cohort study

The factors associated with the outcome of trial of labour after one previous Caesarean Section; a retrospective cohort study. A retrospective observational study was performed on all eligible consecutive singleton pregnancies planned for trial of labour after one previous Caesarean Section (TOLAC) over a period of 18 months to study the success rate of vaginal birth after Caesarean Section (VBAC) and to find out the factors associated with successful and failed TOLAC. All of the data were entered in electronic format and the data was analysed in detail. Of the 1324 women studied, the VBAC rate was 65.3% and the incidence of scar rupture was 0.5%. The composite adverse maternal (postpartum haemorrhage and intensive care admission) and foetal outcome (still birth, 5–minute APGAR <7 and NICU admission) was more in the failed TOLAC group. Various demographic, clinical and obstetric factors were studied in detail between the successful and failed TOLAC groups. The favourable Bishop Score (>4) was independently associated with successful TOLAC (OR 4.3; 95% CI 3.3–5.6 p < .001). Maternal age of >30 years, (OR 0.57; 95% CI 0.41–0.79; p = .001), labour induction (OR 0.43; 95% CI 0.33–0.56; p < .001) and estimated foetal weight of >3500 g (0.31; 95% CI 0.14–0.6; p = .002) were the factors independently associated with failed TOLAC. Previous indication for a Caesarean Section and previous vaginal delivery were not found to be independently associated with the outcome of TOLAC. The predictive models for TOLAC need to be used cautiously and the risk assessment should be done on an individual basis. IMPACT STATEMENT What is already known on this subject? TOLAC is a reasonable strategy in Obstetrics especially after one Caesarean Section to minimise the morbidity associated with rising Caesarean Section. However, the maternal and foetal morbidity are more following unsuccessful TOLAC. The factors which predict the outcome of TOLAC are multifactorial which include maternal demographic factors, previous obstetric factors like indication for Caesarean Section, intraoperative complications, inter-pregnancy interval, current obstetric factors such as gestational age, Bishop Score before delivery, labour factors and foetal factors, e.g. sex and foetal size. What do the results of this study add? We tried to include all the possible factors which probably influence TOLAC and found only Bishop Score, maternal age, foetal size and labour induction were the factors independently associated with the outcome of TOLAC. A Bishop Score of >4 admission was the greatest predictor of successful TOLAC (OR 4.3). Similarly, labour induction and foetal size of >3.5 kg were associated with 60% and 70% less chance of VBAC, respectively. What are the implications of these findings for clinical practice and/or further research? The factors found to be associated with successful and failed TOLAC may be utilised to develop a predictive model. More so, prospective studies are needed to test such predictive models.

Comparison of Success Rate of Vaginal Birth after Cesarean Between Women with Lower Segment Uterine Scar Thickness more than and less than 3.5mm

Background: Although scar thickness is been used for predicting vaginal birth among women with previous one cesarean section but which women are good candidates for VBAC, the value of applying sonographic LUS thickness measurement in the management of VBAC remains unclear and there are no clear guidelines in this regard. Objective: To determine the frequency of successful vaginal birth after previous one cesarean section and to compare the frequency of vaginal birth after previous one cesarean section in women with scar thickness &gt;3.5 mm compared to those with scar thickness ≤3.5 mm. Study Design: Descriptive, Case-series study. Settings: Department of Obstetrics &amp; Gynecology, DHQ Hospital, Faisalabad. Duration: Six months from December 15, 2017 to June 15, 2018. Methodology: The Non probability, consecutive sampling technique was used in this study. A total of 151 patients in spontaneous labor at term presented to labor room and fulfilling the inclusion criteria were enrolled in this study. After taking informed written consent, the patients were placed randomly into two groups. Group A included all the women with scar thickness &gt;3.5 mm on ultrasonography while Group B included all the women with scar thickness ≤ 3.5mm on ultrasonography. All cases were followed till delivery and outcome variables like vaginal birth was noted. Data was entered and analyzed through SPSS version 21. Results: Mean age was 27.53 ± 4.93 years. Mean gestational age was 39.09 ± 1.13 weeks. Frequency of successful vaginal birth after previous one cesarean section was found in 131(86.75%) patients, whereas there was no VBAC in 20(13.25%) patients. The results of the study showed that women with scar thickness &gt; 3.5 mm were more likely to have vaginal birth (96.65%) versus those with scar thickness ≤3.5mm (79.27%) (P = 0.003). Conclusion: This study concluded that the frequency of vaginal birth after previous one cesarean section in women with scar thickness &gt; 3.5 mm is much higher as compared to those with scar thickness ≤3.5mm.

Predictors of success of trial of labor after cesarean section: A nested case-control study at public hospitals in Eastern Ethiopia.

Background:One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia.Methods:A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings.Results:We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial.Conclusion:Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.

Factors affecting the success rate of vaginal birth after cesarean section

Introduction: The success rate of vaginal birth after cesarean section (VBAC) varies among institutions and health care providers. It is also affected by various antepartum, intrapartum factors as well as the difference in the obstetric population. Objectives: The main aim of the study is to determine the factors that affect the success rate of vaginal birth after cesarean section. This will help us to choose the right patients for VBAC thereby decreasing the complications of an emergency cesarean section. Methods: This is a prospective, cohort study done over a period of twelve months. Based on the patient's preference a total of 211 women were divided into two groups either a trial of labor after cesarean section (TOLAC) or elective repeat cesarean section (ERCS) group. VBAC group was compared with the failed trial of labor group to determine the factors affecting the success rate. Result: The success rate of VBAC was found to be 47.9%. About 15% of failed VBAC was due to the tendency to abandon a TOLAC midway. The success rate of VBAC increased in women with previous vaginal delivery and in those who went into spontaneous labor. Epidural was found to be safe to use in the trial of the labor group. Conclusion: Women with factors that increase the likelihood for vaginal delivery following cesarean section should be motivated well and referred to a tertiary center to improve the success rate as well as to reduce the maternal and fetal morbidity

Effect of epidural analgesia in trial of labor after cesarean on maternal and neonatal outcomes in China: a multicenter, prospective cohort study

BackgroundThe trial of labor after cesarean section (TOLAC) is a relatively new technique in mainland of China, and epidural analgesia is one of the risk factors for uterine rupture. This study aimed to evaluate the effect of epidural analgesia on primary labor outcome [success rate of vaginal birth after cesarean (VBAC)], parturient complications and neonatal outcomes after TOLAC in Chinese multiparas based on a strictly uniform TOLAC indication, management and epidural protocol.MethodsA total of 423 multiparas undergoing TOLAC were enrolled in this study from January 2017 to February 2018. Multiparas were divided into two groups according to whether they received epidural analgesia (study group, N = 263) or not (control group, N = 160) during labor. Maternal delivery outcomes and neonatal characteristics were recorded and evaluated using univariate analysis, multivariable logistic regression and propensity score matching (PSM).ResultsThe success rate of VBAC was remarkably higher (85.55% vs. 69.38%, p < 0.01) in study group. Epidural analgesia significantly shortened initiating lactation period and declined Visual Analogue Score (VAS). It also showed more superiority in neonatal umbilical arterial blood pH value. After matching by PSM, multivariable logistic regression revealed that the correction of confounding factors including epidural analgesia, cervical Bishop score at admission and spontaneous onset of labor were still shown as promotion probability in study group (OR = 4.480, 1.360, and 10.188, respectively; 95%CI = 2.025–10.660, 1.113–1.673, and 2.875–48.418, respectively; p < 0.001, p = 0.003, and p < 0.001, respectively).ConclusionsEpidural analgesia could reduce labor pain, and no increased risk of postpartum bleeding or uterine rupture, as well as adverse effects in newborns were observed. The labor duration of multiparas was increased, but within acceptable range. In summary, epidural analgesia may be safe for both mother and neonate in the three studied hospitals.Trial registrationChineses Clinical Trial Register, ChiCTR-ONC-17010654. Registered February 16th, 2017.

Safety and success rate of vaginal birth after two cesarean sections: retrospective cohort study.

Cesarean section is a lifesaving procedure with short and long-term consequences. Growing rates of cesareansections worldwide arise problems for subsequent birth. The aim of this study was to compare safety of vaginal birthafter two cesarean sections with repeat third cesarean section to help healthcare providers and patients make well informeddecisions about mode of subsequent delivery. This was a retrospective cohort study conducted in a tertiary reference hospital. Database of alldeliveries (2010-2017) after two previous cesarean sections was created from electronic and paper medical records. Pretermdeliveries, abnormal karyotype and neonates with congenital anomalies were excluded from the study. The final analysisincluded 412 cases for maternal outcome analysis and 406 cases for neonatal outcome analysis. Trial of labor after two cesareans in comparison to repeat cesarean section increases the risk of hemorrhage(OR: 10.84) and unfavorable composite maternal outcome (OR: 2.58). Failed trial of labor increases this risk of hemorrhage(OR: 15.27) and unfavorable composite maternal outcome (OR: 4.59) even further. There were no significant differences in neonataloutcomes. 22 out of 35 trials of labor ended in successful delivery giving a success rate of 62.85%. 5 of 7 labor inductionsended in repeat cesarean section giving 28.6% success rate. There were no maternal deaths and emergency hysterectomies. Trial of labor, especially failed trial of labor, is associated with an increased risk of perinatal complications.

Development of a Modified Score System as Prediction Model for Successful Vaginal Birth After Cesarean Delivery.

This study was designed to establish a modified prediction score system to improve the safety and success rate of vaginal birth after cesarean delivery (VBAC). We recruited 406 patients (between January 2012 and December 2016) and generated a modified score system in predicting the success rate of VBAC. All patients were required to sign informed consent forms. There were 87.2% of patients who had successful VBAC deliveries and 12.8% patients who had repeated cesarean sections. We conducted multivariable logistic regression and found seven variables that were associated with VBAC success, including previous primary indication of cesarean delivery (odds ratio (OR), 2.1; 95% confidence interval (CI), 1.4–3.0), previous vaginal birth history (OR, 2.5; 95% CI, 1.8–3.8), < 40 years of age (OR, 2.1; 95% CI, 1.2–3.3), < 20 kg weight gain (OR, 1.5; 95% CI, 1.2–2.3), no labor induction (OR, 1.9; 95% CI, 1.5–2.9), high score of pelvic/birth weight (OR, 1.4; 95% CI, 1.1–2.1), and Bishop score (OR, 1.3; 95% CI, 1.2–1.4). After adjustment for optimism, the area under the receiver operating characteristic curve (AUC‐ROC) was 0.849 (95% CI, 0.78–0.89), and the modified VBAC score was positively correlated with the success rate of trial of labor after cesarean delivery (TOLAC). A valid and useful score system was established to predict VBAC success rate.

Factors Associated with Success Rate of Vaginal Birth after One Caesarean Section (VBAC) in Ibrahim Malik Teaching Hospital, Khartoum-Sudan

Factors Associated with Success Rate of Vaginal Birth after One Caesarean Section (VBAC) in Ibrahim Malik Teaching Hospital, Khartoum-Sudan