The failure rate and related factors of vaginal delivery after caesarean section

ABSTRACT

Objective. In women with a previous caesarean section, whichever choice of mode of delivery ‒Elective Repeat Caesarean Section (ERCS) or Trial of Labour After Caesarean (TOLAC) ‒ there is not an option free from risks for both the woman and the foetus. The main focus of this study was the successful rate of VBAC.
Patients and Methods. We conducted a retrospective cohort study of pregnant women from 2015 to 2019 who had a previous caesarean delivery. In the selected timeframe, 199 women with a previous caesarean gave birth. The criteria of inclusion were to have had only one previous caesarean section and no previous vaginal deliveries.
The subjects were initially divided into TOLAC or ERCS. Then, the patients from the first group were further divided into successful group and failure group.
Results. Comparing the outcomes of women admitted to trial of labour and those of women who planned a repeat caesarean, we found that maternal age over 35 years was the most important factor influencing the choice of not admitting a woman to trial of labour (OR = 0.38; CI 95%: 0.21-0.69). Moreover, 81.5% of women giving birth at term had a TOLAC vs the 18.5% of women in the elective repeat caesarean section group (OR = 4.83; CI 95%: 2.36-9.84).
Conclusions. There were no significant differences between the successful VBAC group and the failure group (who underwent a caesarean section during trial of labour) in regard to nationality, marital status, level of education, maternal age, gestational age at delivery and birth weight.