Rate of successful vaginal birth in post first caesarean pregnancies at Sayed Galal University Hospital

Abstract EN

Maternal morbidity associated with caesarean section is five to ten times greater than that associated with vaginal delivery.

Attempting a vaginal birth after a single previous low transverse caesarean section (VBAC) is associated with a lower risk of complications for both mother and baby than an elective repeat caesarean section.

The advantages of attempting a VBAC include a lower risk of maternal death or disability and illness, a lower rate of respiratory problems in the newborn and the elimination of the risk of miscalculated prematurity.

Patients and methods : This study aimed to estimate rate of successful vaginal birth after first cesarean pregnancies in Sayed Galal university hospital and the associated maternal, neonatal morbidity and mortality.

This prospective study was carried out on two hundred women with one previous lower segment cesarean section (LSCS) for a non recurrent cause, from 1st May, 2012 to 30th September, 2012.

All women had only one previous lower segment cesarean section and admitted from emergency room with spontaneous labor, and then admitted to delivery room for trial of normal vaginal delivery.

Results : From these two hundred patients 120 women delivered virginally, 100 of them delivered spontaneously and had easy deliveries.20 patients need vacuum extraction to accelerate the second stage of labor.

80 women needed emergency LSCS.

Patients who had previous vaginal delivery (80 cases) had Higher success rate of vaginal delivery after previous cesarean vs.

those who had none (120 cases) (75 % vs.

50 % p <.OO 1, Normal test), 60 of 80 cases had previous normal vaginal deliveries were delivered by normal vaginal delivery again, and 60 of 120cases had no normal vaginal delivery before were delivered by normal vaginal delivery.

Prior cesarean section indication due to breech and other malpresentations had a highest success rate of 86 %, fetal distress had success rate of vaginal birth of 82 %.

Conclusion : Vaginal birth in post cesarean pregnancies in Sayed Galal university hospital has success rate of 60 %, previous vaginal delivery certainly is a predictor for success.

The indication for prior cesarean did not influence the decision for vaginal delivery provided there are no contraindications.