Vaginal birth after caesarean section in a population with a low overall caesarean section rate.
OBJECTIVE
To determine the clinical outcome of vaginal birth after caesarean section (VBAC) in a Dutch population with a low overall caesarean section (CS) rate of 6.5%.


METHODS
Prospective population based cohort study of 252 patients with a previous caesarean section (CS). Outcome parameters were trial of labour (TOL), success rate and VBAC rate.


RESULTS
The TOL rate in the study cohort was 73%, success rate 77%, VBAC rate 56%. The reason for the previous CS influenced success rate. Complications, morbidity and mortality were not different between elective, emergency CS and TOL group, except for a higher incidence of haemorrhage more than 500 ml in the elective CS compared to the TOL group (29% versus 17%, relative risk (RR) 1.74 (1.15--2.34)).


CONCLUSIONS
In this Dutch study the success rate is comparable to rate in US study reports. Increase of the VBAC rate can mainly be achieved by increasing the number of women attempting TOL.
Bais
J M
JM
Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
van der Borden
D M
DM
Pel
M
M
Bonsel
G J
GJ
Eskes
M
M
van der Slikke
H J
HJ
Bleker
O P
OP
D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004420:Dystocia / Q000453:epidemiology; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009426:Netherlands; D007744:Obstetric Labor Complications; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012782:Shoulder; D016896:Treatment Outcome; D014219:Trial of Labor; D014597:Uterine Rupture / Q000150:complications; D016064:Vaginal Birth after Cesarean