![]() | Only 14 pages are availabe for public view |
Abstract The practice of elective repeated cesarean section (CS) has been changing gradually after the publication of numerous studies that have substantiated the efficacy and safety of a trail of vaginal birth after CS. The aim of this study was to; evaluate the factors (demographic, obstetrical, and medical) that may influence the chances of vaginal birth after cesarean delivery in order to develop accurate prediction score for safe and successful vaginal birth after cesarean delivery. Subjects and Methods: The study included 250 parturient women who were selected purposively with previous one lower segment CS. Informed consent was taken for the trail of VBAC, and then every woman was allowed to undergo the trail of labor, if there were no contraindications for such trial. Results: The results revealed that, 77.6 % of women delivered vaginally and 22.4% had emergency repeated CS. Trial of labor success rates were affected by maternal age, parity, gestational age, history of prior vaginal delivery inter-delivery duration between the previous CS and the current pregnancy, previous attempt ofVBAC, indication of previous CS, BMI, Bishop score on admission, type of labor, and neonatal weight. Conclusions: It can be concluded that, the variables of significant predictive value were; Bishop score (~4), prior vaginal delivery, BMI 30kg/m2, birth weight 4.000Kg, and noncurrent indications of previous the CS. The proposed VBAC score may help to identify women with a greater chance for successful VBAC. Recommendation: The trail of labor should be done under close matemal and fetal monitoring in a hospital with appropriate facilities and services for immediate CS in urgent cases. Also, the midwives should discuss the relevant demographic, historical obstetrics, ante-partum, and intra-partum factors which may influence the likelihood of success or risk ofVBAC with their clients. |