Mode of delivery after one cesarean section.
OBJECTIVE
To investigate labor patterns and mode of delivery of aginal births after cesarean (VBAC) versus unsuccessful trial of labor after cesarean (TOLAC) in a South African district hospital, and the influence of the indication for the primary cesarean section (C-section) on the subsequent mode of delivery.


METHODS
Retrospective audit of the partogram of 202 VBAC and 382 repeat C-section. There were 108 elective repeat cesarean deliveries (ERCD) and 274 emergency repeat C-sections after unsuccessful TOLAC. The indication of the primary C-section was known in 127: 43 (33.9%) VBAC and 84 (66.1%) repeat C-sections.


RESULTS
The indication for the primary C-section in terms of recurrent/non-recurrent did not affect the subsequent mode of delivery (chi(2)=3.5; P=0.06; OR 0.49, 95% CI 0.23-1.04). The indication of the primary C-section in terms of dysfunctional/non-dysfunctional labor did not reoccur in the same parturients (chi(2)=0.01; P=0.91; OR 0.94, 95% CI 0.35-2.55).


CONCLUSIONS
Dysfunctional labor accounted for most primary and repeat emergency C-sections, but not as a recurrent condition in the same parturients.
van Bogaert
L-J
LJ
Department of Obstetrics and Gynecology, MEDUNSA Satellite Campus, Philadelphia Hospital, Dennilton, South Africa. ljfvanbo@lantic.net
D000328:Adult; D005260:Female; D020073:Gravidity; D006767:Hospitals, District; D006801:Humans; D007743:Labor, Obstetric; D007744:Obstetric Labor Complications / Q000601:surgery; D010298:Parity; D011247:Pregnancy; D012008:Recurrence; D012189:Retrospective Studies; D013019:South Africa; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data