Vaginal Birth after Cesarean Section (VBAC) Success Rate and Predictors of Success in a Tertiary Care Hospital

Kausar Masoom; Rafia Asif; Yasmeen Aara; Noshela Javaid; Sobia Luqman; Shumaila Naeem

Kausar Masoom Associate Professor, Mother and Child Health Care Central, Unit II, Pakistan Institute of Medical Sciences, Islamabad
Rafia Asif PG, Mother and Child Health Care Central, Unit II, Pakistan Institute of Medical Sciences, Islamabad
Yasmeen Aara Assistant Professor, Mother and Child Health Care Central, Unit 2, Pakistan Institute of Medical Sciences, Islamabad
Noshela Javaid Associate Professor Mother and Child Health Care Central, Unit 2, Pakistan Institute of Medical Sciences, Islamabad
Sobia Luqman Assistant Professor Mother and Child Health Care Central, Unit 2, Pakistan Institute of Medical Sciences, Islamabad
Shumaila Naeem Assistant Professor, Mother and Child Health Care Central, Unit II, Pakistan Institute of Medical Sciences, Islamabad

Keywords: Vaginal Birth after C-section, Low Segment Cesarean Section

Abstract

Objective: The major objective of this study is to evaluate the predictor for a successful VBAC in a busy tertiary care hospital and assess the success rate in the cases of previous Lower Segment Caesarean Section (LSCS).

Methodology: This retrospective study was carried out at a tertiary care teaching hospital PIMS MCH-II from March 2019 to August 2019. The study involved 160 cases of the previous one lower segment CS duty approved from the ethical committee. The exclusion was based on patients with more than one CS. Twins, history of uterine rupture, other scars on the uterus or scar dehiscence, previous classical or inverted T-shaped incision, contracted pelvis, cephalopelvic disproportion, abnormal and presentation. Patients with other medical or obstratical complications were also excluded from the study. Medical complications were also excluded from the study.

Results: 10% of the induced cases went for VBAC while 90% induced cases went for C-section. On the other hand, 58.8% of the spontaneous cases went for VBAC while 41.2% of the spontaneous women went for C-section. 62.8% booked patients were delivered via VBAC versus 13.6% of non-booked while 37.2% delivered via LSCS were booked versus 86.4% of non-booked.

Conclusion: The main predictors noticed, included evaluation assurance and counselling by a senior obstetrician, proper antenatal care, gestational age, BMI of the mother, spontaneous onset of labour, and engagement of the fetal head, estimated fetal weight. Confidence building reassurance about progress and status of the study claims safe delivery by the vaginal route without any major complications to the mother and newborn.