Global Advanced Research Journal of Medicine and Medical Sciences (ISSN: 2315-5159)
November 2016, Vol. 5(11) pp. 278-282
Copyright © 2016 Global Advanced Research Journals
Full Length Research Paper
Outcome of Trial of Labour after Caesarean Section at King Khalid University Hospital
Hayfaa A Wahabi
Chair of Evidence-based Health Care and Knowledge Translation, College of Medicine, Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia.
Email: firstname.lastname@example.org; Phone: 00 966 1146 92712; Fax: 00 966 11 46 91341
Accepted 10 November, 2016
The aims of this study were to detect the prevalence of vaginal birth after caesarean section (CS) and to investigate the risk factors and the complications associated with failure of trial of labour after CS, (TOLAC). A prospective cohort of women who had one lower segment CS in any previous delivery and who were admitted for TOLAC, during 12 months period, was included in this study. Women who had successful vaginal delivery following TOLAC were compared to those who had repeat CS due to failure of VBAC, with respect to maternal age, parity, previous vaginal delivery, gestational age and birth weight. In addition to the following adverse outcomes; rate of APGAR score, low cord blood pH, rate of uterine rupture, need for blood transfusion and admission to intensive care unit. Two hundred and eighty two women were included. Of those 204 women (72.3 %) had vaginal birth while 78 (27.8 %) were delivered by emergency CS. Three factors were predictive of failed TOLAC; older maternal age, odds ratio (OR) 1.1, 95% confidence intervals (CI) (1.01-1.16), p=0.03, smaller gestational age, OR 0.7, 95% CL (0.6-0.9), p <0.01, and lack of previous vaginal delivery, OR 0.17, 95% CI (0.08-0.34), p<0.001. Both groups did not have adverse maternal or neonatal outcomes. In conclusion, TOLAC has a success rate comparable to other centers in the worlds. It contributes significantly to reducing the rate of CS without increasing the maternal or perinatal morbidities. Previous normal vaginal delivery is a strong predictor of successful VBAC.
Keywords: Trial of labour after caesarean section-vaginal, birth after caesarean section-risk, factors for failed trial of labour