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Vaginal Birth after Cesarean Delivery: Results in 310 Pregnancies
Author(s) -
Obara Hiromi,
Minakami Hisanori,
Koike Toshimitsu,
Takamizawa Satoru,
Matsubar Shigeki,
Sato Ikuo
Publication year - 1998
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.1998.tb00063.x
Subject(s) - medicine , uterine rupture , obstetrics , asphyxia , vaginal birth , apgar score , vaginal delivery , pregnancy , medical record , gestation , retrospective cohort study , gynecology , gestational age , uterus , surgery , biology , genetics
Objective : To assess and compare the risk associated with a trial of vaginal birth after cesarean section (VBAC) with the risk of an elective repeat cesarean section. Methods: A retrospective review of the records of 310 consecutive women who, at the Jichi Medical School Hospital in the 6‐year period of 1990 through 1995, had previously undergone a primary cesarean section and gave birth to a singleton infant weighing ≥ 2,000 g at ≥ 36 weeks of gestation in a subsequent pregnancy. Results: Elective cesarean sections were performed on 96 (31%) of 310 women, and VBACs were attempted by 214 women (69%). Vaginal deliveries were successful in 132 (43%) of the 310 pregnancies. No maternal deaths or perinatal deaths occurred in either group. A uterine rupture occurred in 2 (0.9%) of the 214 women who attempted a VBAC, and 5 women (2.3%) gave birth to neonates with a 1‐minute Apgar score ≤ 6. None of the 96 women who underwent an elective cesarean section had such complications, although the difference in these complication rates did not reach a significant level. Conclusions : A trial of a VBAC significantly reduced the rate of cesarean sections. Although the rates of uterine rupture and neonatal asphyxia were slightly higher in women who attempted a VBAC than in women who underwent an elective cesarean section, obstetricians should offer the option of a trial of labor, because more than one‐half of the women with a previous cesarean delivery might have successful vaginal deliveries, and the VBAC‐related maternal mortality rate does not reportedly differ between women undergoing a trial of labor and women undergoing an elective repeat cesarean section.