Predictors of successful vaginal delivery after previous caesarean section in a Nigerian tertiary hospital.
Achieving a successful vaginal birth after a previous caesarean section (VBAC) is an important strategy in reducing the rising rate of caesarean section and its associated morbidities. Records of 188 women attempting trial of vaginal delivery after a previous lower segment caesarean section were reviewed to predict factors favouring successful vaginal delivery. Of the 188 women, 64 had recurrent indications for caesarean section, while 124 had non-recurrent indications. The group with recurrent indications for previous caesarean section had less vaginal delivery and more repeat caesarean sections as compared with the group with non-recurrent indications (21.9% and 78.1% vs 46.8% and 53.2%, respectively, p = 0.01). Cephalopelvic disproportion was more frequent in the group with recurrent indications (65.6% vs 27.4%, p < 0.0001). Significant predictors of successful VBAC in this cohort of women were non-recurrent indications for the previous caesarean section (p < 0.001, odds ratio (95% CI) 0.32 (0.2-0.6)) and a previous vaginal delivery (p < 0.0001, odds ratio (95% CI) 3.90 (2.1-7.4)). A previous vaginal delivery and a non-recurrent indication for the previous caesarean section are important predictors of VBAC in this cohort of women.
Olagbuji
B
B
Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Ezeanochie
M
M
Okonofua
F
F
D000328:Adult; D002585:Cesarean Section; D005260:Female; D005544:Forecasting; D006801:Humans; D009549:Nigeria / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000401:mortality* / Q000639:trends*