Incidence of vaginal birth after cesarean section in Al-Zahraa Maternity and Pediatrics Teaching Hospital
DOI:
https://doi.org/10.18370/2309-4117.2024.75.32-36Keywords:
labor, vaginal delivery, cesarean section, vaginal birth after cesareanAbstract
Background. As we approach the centennial of the maxim «Once a cesarean, always a cesarean,» the debate over the safety and viability of vaginal birth after cesarean (VBAC) continues. With cesarean section (CS) rates climbing globally, there is a revitalized interest in VBAC as a means to reduce maternal and neonatal morbidities associated with repeated cesarean operations. Objective of the study: to evaluate the incidence of VBAC at Al-Zahraa Maternity and Pediatrics Teaching Hospital (Iraq) and identify risk factors those influence the success or failure in trials of labor after cesarean section (TOLAC).
Materials and methods. This observational study conducted at Al-Zahraa Maternity and Pediatrics Teaching Hospital from October 2023 to April 2024 involved women who had undergone one previous CS. During this time, comprehensive demographic and medical data were collected from participants to assess the outcomes of TOLAC in this population. Obtained data were analyzed using various statistical tools to identify trends and outcomes associated with TOLAC attempts.
Results. Among 418 study participants, 268 (64.1%) attempted TOLAC, with a VBAC success rate of 39.20% (from the total study sample representing 61.2% of TOLAC cases). Statistical analysis revealed that older women, those with a longer interval since their last CS, and those with a history of previous vaginal delivery or previous VBAC demonstrated higher success rates. Common impediments to successful VBAC included labor progression issues and fetal distress.
Conclusions. VBAC is viable and reduces risks linked to repeated CS, with a 39.20% success rate among those attempting TOLAC. Success factors include longer intervals since the last CS and no major comorbidities. Common barriers to successful VBAC include labor progression issues and fetal distress.
References
- Cragin EB. Conservatism in obstetrics. NY Med J 1916; 104:1–3. (Level III)
- American College of Obstetricians and Gynecologists. Vaginal Birth After Cesarean Delivery. ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery Obstet Gynecol 2019 Feb;133(2):e110-e127. DOI: 10.1097/AOG.0000000000003078
- Hamilton BE, Martin JA, Osterman MJ, et al. Births: provisional data for 2016. [Internet] Vital Statistics Rapid Release No 2. Hyattsville (MD): National Center for Health Statistics; 2017. (Level II-3). Available from: https://www.cdc.gov/nchs/data/vsrr/report002.pdf
- Hibbard JU, Ismail MA, Wang Y, et al. Failed vaginal birth after a cesarean section: how risky is it? Am J Obstet Gynecol. 2001; 184: 1365–73. DOI: 10.1067/mob.2001.115044
- Landon, M. B., Hauth, J. C., Leveno, K. J., et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. New England Journal of Medicine, 2004; 351: 2581–9. DOI: 10.1056/NEJMoa040405
- Guise, J. M., Eden, K., Emeis, C., et al. Vaginal Birth After Cesarean: New Insights. Evid Rep Technol Asses. 2010 Mar:(191):1–397.
- Dodd JM, Crowther CA, Grivell RM. Vaginal birth after caesarean versus elective repeat caesarean for women with a single prior caesarean birth: a systematic review of the literature. Aust N Z J Obstet Gynaecol, 2013; 53(3): 225–33. DOI: 10.1111/j.1479-828X.2004.00257.x.
- Kumari N, Jain N, Dhar RSG. Effect of a locally tailored clinical pathway tool on VBAC outcomes in a private hospital in India. The Journal of Obstetrics and Gynecology of India. 2021;71:246–53. DOI: 10.1007/s13224-021-01446-5
- Aslam M, Khan MA, Habib F, Sadiq H, Habib M. Outcome of pregnancy in the previous cesarean section comparing elective versus trial of labor (VBAC) at KRL Hospital, Islamabad. The Professional Medical Journal. 2023;30(07):906–11. DOI:10.29309/TPMJ/2023.30.07.7400
- Fattah CN, Jalal H. Vaginal Birth After Previous Caesarean Section. Kurdistan Journal of Applied Research. 2017;2(2):36–44. DOI:10.24017/science.2017.2.5
- Ali I, Neamah DA, Hussein MN. Successful vaginal birth after caesarian section and maternal outcome. [Internet] The Pharma Innovation Journal. 2019;8(7):428–33. Available from: https://www.thepharmajournal.com/archives/2019/vol8issue7/PartH/8-4-132-893.pdf
- Eleje GU, Okam PC, Okaforcha EI, Anyaoku CS. Rates and determinants of successful vaginal birth after a previous caesarean section: a prospective cohort study. ARC J Gynecol Obstet. 2019;4(2):1–8. DOI:10.20431/2456-0561.0402001
- Birara M, Gebrehiwot Y. Factors associated with the success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia: a case control study. BMC Pregnancy and Childbirth. 2013;13(1):31.
- Tilva KK, Jethwani D, Dhruva G. Histopathological evaluation of endometrial curettage in cases of abnormal uterine bleeding and its correlation with patient age. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2022;11(10):2687–92. DOI:10.18203/2320-1770.ijrcog20222463
- Juhasz G, Gyamfi C, Gyamfi P, et al. Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery. Obstet Gynecol. 2005;106(4):741–6. DOI:10.1097/01.AOG.0000177972.32941.65
- Wu Y, Kataria Y, Wang Z, et al. Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2019;19:1–12. DOI: 10.1186/s12884-019-2517-y.
- Obeidat N, Meri Z, Obeidat M, et al. Vaginal birth after caesarean section (VBAC) in women with spontaneous labour: predictors of success. Journal of obstetrics and gynaecology. 2013;33(5):474–8. DOI: 10.3109/01443615.2013.782275
- Kalok A, Zabil SA, Jamil MA, et al. Antenatal scoring system in predicting the success of planned vaginal birth following one previous caesarean section. J Obstet Gynaecol. 2018;38(3):339–43. DOI: 10.1080/01443615.2017.1355896
- La Verde M, Cobellis L, Torella M, et al. Is uterine myomectomy a real contraindication to vaginal delivery? Results from a prospective study. J Invest Surg. 2022;35(1):126–31. DOI: 10.1080/08941939.2020.1836289
- Tambe SG, Mulay AS. A study to evaluate feto-maternal outcome of trial of labour in previous cesarean patients: a prospective observational study at a tertiary care centre in India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2022;11(10):2680. DOI: 10.18203/2320-1770.ijrcog20222462
- Familiari A, Neri C, Caruso A, et al. Vaginal birth after caesarean section: a multicentre study on prognostic factors and feasibility. Archives of gynecology and obstetrics. 2020;301:509–15. DOI: 10.1007/s00404-020-05454-0
- Grylka-Baeschlin S, Clarke M, Begley C, et al. Labour characteristics of women achieving successful vaginal birth after caesarean section in three European countries. Midwifery. 2019;74:36–43. DOI: 10.1016/j.midw.2019.03.013
- Gitas G, Proppe L, Ertan A, et al. Influence of the second stage of labor on maternal and neonatal outcomes in vaginal births after caesarean section: a multicenter study in Germany. BMC Pregnancy Childbirth. 2021; May 4;21(1):356. DOI: 10.1186/s12884-021-03817-2
- Pergialiotis V, Bellos I, Antsaklis A, et al. Maternal and neonatal outcomes following a prolonged second stage of labor: A meta-analysis of observational studies. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020;252:62–9. DOI: 10.1016/j.ejogrb.2020.06.018
- Kassa Mamo N, Melese Siyoum D. Factors associated with successful vaginal birth after cesarean section among mothers who gave birth in Ambo town, Oromia, Central Ethiopia, a case-control study. African Health Sciences. 2022;22(4):357–67. DOI: 10.4314/ahs.v22i4.41.
- Melamed N, Segev M, Hadar E, et al. Outcome of trial of labor after cesarean section in women with past failed operative vaginal delivery. American journal of obstetrics and gynecology. 2013;209(1):49. e1–e7. DOI: 10.1016/j.ajog.2013.03.010
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.