Predictors of Successful Vaginal Deliveries after Previous one Caesarean

Shaheera Akram; Shazia  Chohan; Viqar  Ashraf; Asifa  Siraj; Mafia  Toheed; Rabiah  Anwar

doi:10.51253/pafmj.v76i6.12543

Authors

Shaheera Akram Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Shazia Chohan Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Viqar Ashraf Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Asifa Siraj Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Mafia Toheed Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Rabiah Anwar Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i6.12543

Keywords:

BISHOP Score, Placenta Previa, Trial of Labor After a Caesarean (TOLAC), Vaginal Birth After a Caesarean (VBAC).

Abstract

Objective: to compare the outcomes in patients undergoing TOLAC after one LSCS and find out successful predictors for vaginal delivery in those who have delivered vaginally in comparison to those who end up in repeat C-section.

Study Design: Prospective comparative study.

Place and Duration of Study: Department of Gynecology and Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2023 to June 2024.

Methodology: Three hundred women of reproductive age group with previous single caesarean deliveries were included in the study. The demographics, obstetric history, index pregnancies, and medical details of each case were examined. Induction of labour, BISHOP score upon admission, BMI, gestational age at delivery, estimated foetal weight, intrapartum features, mode of delivery, previous vaginal delivery and intraoperative observations were all noted.

Results: A total three hundred (n=300) patients were included 150(50.0%) of the cases resulted in a successful vaginal delivery, whereas 150(50.0%) underwent repeat caesarean delivery. The overall success rate of VBAC after exclusion of caesarean cases due to maternal requests was 73.0%. Methods of labour inductions were as follows: balloon (n=20), oxytocin (n=64), balloon followed by oxytocin (n=18), vaginal PGE2 (n=2), balloon followed by vaginal PGE2 (n=4), c-section followed by relaparotomy due to intrapelvic hematoma (n=1), dehiscence (n=7). Multiple regression analysis showed BISHOP score at admission were statistically significant difference (p-value=0.001; 95% Cl= 0.023 – 0.095). Women with a BMI of less than 28 had a two times of giving .....

Conclusion: The BISHOP score upon admission, TOLAC score, body mass index, number of prior.....

Downloads

Download data is not yet available.

References

1. Parveen S, Rengaraj S, Chaturvedula L. Factors associated with the outcome of TOLAC after one previous caesarean section: a retrospective cohort study. J Obstet Gynaecol 2022; 42(3): 430-436. http://doi.org/10.1080/01443615.2021.1916451

2. Addisu D, Gebeyehu NA, Biru S, Belachew YY. Vaginal birth after cesarean section and its associated factors in Ethiopia: a systematic review and meta-analysis. Sci Rep 2023; 13(1): 7882.

http://doi.org/10.1038/s41598-023-34856-8

3. Deng B, Li Y, Chen JY, Guo J, Tan J, Yang Y, et al. Prediction models of vaginal birth after cesarean delivery: A systematic review. Int J Nurs Stud 2022; 135: 104359.

http://doi.org/10.1016/j.ijnurstu.2022.104359

4. Zhang HL, Zheng LH, Cheng LC, Liu ZD, Yu L, Han Q, et al. Prediction of vaginal birth after cesarean delivery in Southeast China: a retrospective cohort study. BMC Preg Childbirth 2020; 20(1): 538. http://doi.org/10.1186/s12884-020-03233-y

5. Mi Y, Qu P, Guo N, Bai R, Gao J, Ma Z, et al. Evaluation of factors that predict the success rate of trial of labor after the cesarean section. BMC Preg Childbirth 2021; 21(1): 527.

http://doi.org/10.1186/s12884-021-04004-z

6. Jasim SK, Al-Momen H, Wahbi MA, Almomen R. Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad. J Turk Ger Gynecol Assoc 2023; 24(2): 86-91.

http://doi.org/10.4274/jtgga.galenos.2023.2022-7-11

7. Fitzpatrick KE, Kurinczuk JJ, Bhattacharya S, Quigley MA. Planned mode of delivery after previous cesarean section and short-term maternal and perinatal outcomes: A population-based record linkage cohort study in Scotland. PLoS Med 2019; 16(9): e1002913.http://doi.org/10.1371/journal.pmed.1002913

8. Fitzpatrick KE, Kurinczuk JJ, Quigley MA. Planned mode of birth after previous caesarean section and special educational needs in childhood: a population-based record linkage cohort study. Br J Obstet Gynaecol 2021; 128(13): 2158-2168.

http://doi.org/10.1111/1471-0528.16828

9. Joseph KS, Young CB, Muraca GM, Boutin A, Razaz N, John S, et al. Hospital factors associated with maternal and neonatal outcomes of deliveries to patients with a previous cesarean delivery: an ecological study. Can Med Assoc J 2023; 195(5): E178-E186. http://doi.org/10.1503/cmaj.220928

10. Wilson RD. Fostering Excellence in Obstetrical Surgery. J Healthc Leadersh 2023; 15: 355-373.

http://doi.org/10.2147/JHL.S404498

11. Sahin S, Ozkaya E, Eroglu M, Sanverdi I, Celik Z, Cakıroglu A. Predictors of successful vaginal birth after a caesarean in women with a previous single caesarean delivery. Eur Rev Med Pharmacol Sci 2022; 26(5): 1594-1600.

http://doi.org/10.26355/eurrev_202203_28226

12. Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021; 6(6): e005671.

http://doi.org/10.1136/bmjgh-2021-005671

13. Tesfahun TD, Awoke AM, Kefale MM, Balcha WF, Nega AT, Gezahegn TW, et al. Factors associated with successful vaginal birth after one lower uterine transverse cesarean section delivery. Sci Rep 2023; 13(1): 8871.

http://doi.org/10.1038/s41598-023-36027-1

14. Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011; 205(3): 262.e1-8.

http://doi.org/10.1016/j.ajog.2011.06.035

15. Grobman WA, Gersnoviez R, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al; National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Pregnancy outcomes for women with placenta previa in relation to the number of prior cesarean deliveries. Obstet Gynecol 2007; 110(6): 1249-1255.

http://doi.org/10.1097/01.AOG.0000292082.80566.cd

16. Stock SJ, Ferguson E, Duffy A, Ford I, Chalmers J, Norman JE. Outcomes of induction of labour in women with previous caesarean delivery: a retrospective cohort study using a population database. PLoS One 2013; 8(4): e60404.

http://doi.org/10.1371/journal.pone.0060404

17. Palatnik A, Grobman WA. Induction of labor versus expectant management for women with a prior cesarean delivery. Am J Obstet Gynecol 2015; 212(3): 358.e1-6.

http://doi.org/10.1016/j.ajog.2015.01.026

18. Reddy BV, Desu SS, Aravindakshan R, Marimuthu Y. Factors Contributing to Rapidly Increasing Rates of Caesarean Section in Andhra Pradesh, India: A Case-Control Study. Cureus 2023; 15(4): e37026. http://doi.org/10.7759/cureus.37026