Revista Chilena de Obstetricia y Ginecología (Jan 2022)

Attempted vaginal birth after cesarean: assessment of morbidity and predictors of success

  • Rocio Garcia-Jimenez,
  • Irene Valero,
  • Ana M. Weber-Fernandez,
  • Natalia Florez,
  • Irene Martinez-Aguado,
  • Carlota Borrero

DOI
https://doi.org/10.24875/RECHOG.22000080
Journal volume & issue
Vol. 87, no. 6

Abstract

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Objective: Determining the appropriate approach for delivery after previous cesarean is a very controversial issue. Our objective was to establish whether pregnant women with a previous cesarean have an increased maternal and fetal morbidity and mortality after attempting vaginal delivery as well as to determine which factors may influence the achievement of a vaginal birth after cesarean. Materials and methods: A retrospective observational cohort study including 390 patients (196 cesarean group and 194 nulliparous group) was carried out. We compared neonatal and maternal outcomes between groups. Afterward, a multivariate logistic regression was applied for our second objective. Results: There were higher rates of uterine rupture (2% vs. 0%, p: 0.045) and puerperal hemorrhage (9.7% vs. 3.1%, p: 0.008) in the cesarean group and lower vaginal delivery rate (58.2% vs. 77.8%, p < 0.0005). We found that the induced onset of labor (OR = 2.9) and new born weight (OR = 1.0001) were associated with an increased risk of cesarean section. Conclusions: Our findings stress the need for further investigations in this field, which might provide a basis for a better management of patients with a previous cesarean.

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