title: Vaginal birth after cesarean section. Acceptance and outcome at a rural hospital.
abstract: A retrospective review of all pregnant women with a history of cesarean section was conducted at an isolated military hospital. During the two-year period 1988-1989, 62 patients were initially considered eligible for attempting vaginal birth after cesarean section (VBAC). Seventy-nine percent (49/62) of the patients initially requested a trial of labor, and 14 of them ultimately did not meet American College of Obstetricians and Gynecologists criteria. Three patients reversed their decision late in pregnancy. Eighty-eight percent (28/32) of those undergoing a trial of labor delivered vaginally. The three patients with more than one prior cesarean section all delivered vaginally. The four failures occurred in patients who had a history of well-documented cephalopelvic disproportion. Perinatal morbidity consisted of intrauterine fetal demise prior to the onset of labor at 40 weeks' gestation. Maternal morbidity included postcesarean endometritis (n = 1) and vaginal sidewall laceration (n = 1). These results indicate that in a rural hospital VBAC was well accepted by patients and was safe; however, further study is required.
authors.affiliation: 432 Medical Group, Misawa Air Base, Japan.
authors.forename: D L
authors.initials: DL
authors.lastname: Walton
authors.forename: D
authors.initials: D
authors.lastname: Ludlow
authors.forename: D C
authors.initials: DC
authors.lastname: Willis
mesh_terms: D003657:Decision Making; D004716:Endometritis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D014219:Trial of Labor; D014621:Vagina / Q000293:injuries; D016064:Vaginal Birth after Cesarean / Q000523:psychology* / Q000706:statistics & numerical data