Successful Vaginal Birth Subsequent to Ceasarean Section

Abstract

Successful vaginal birth after cesarean section is more comfortable than repeat elective cesarean section. Trial oflabor should take into consideration the patient’s preference, together with the proper setting. Aim: identify factorsaffecting the successful vaginal birth subsequent to cesarean section in order to develop a predictive score for successfultrial. Subject & Methods: a prospective study design at the delivery unit in delivery unit in Mansoura University, Egypt,Egypt. 200 parturient women who were selected purposively with previous one lower segment cesarean section. Astructured interviewing schedule, maternal and neonatal assessment sheet, partograph, labor record; were used for datacollection. Results: revealed that vaginal birth after cesarean section was successful in 76.5% of women and the rest23.5% had failure in vaginal birth after cesarean section and underwent emergency repeated cesarean section. Positivefactors which increase the likelihood of successful vaginal birth after cesarean were; younger women age, gestationalage, parity, duration between the previous cesarean section and the present pregnancy, history of prior vaginal birthbefore the previous CS, and bishop score as well as neonatal weight. Conclusion: maternal age > 25 years, gestationalage >40 weeks, parity more than three, duration between the previous cesarean section and the present pregnancy < 18months , recurrent indication of CS and abnormal fetal condition, , delay in labor progress as well as fetal weight>4,000kg . Furthermore, more problems during the fourth stage of labor were mostly exposed to ERCS.Recommendations: Vaginal birth subsequent to cesarean section trial of labor should be conducted in hospitals, withadequate facilities for immediate delivery and resuscitation of the newborn as well as high quality care and propercounseling from the nurse midwife. Furthermore, factors associated with failure in the successful VBAC as well aswomen with prior cesarean deliveries require special management, both antenatal, in labor and delivery.