A Study of the Causes and the Predictive Factors in Failed Vaginal Birth After Cesarean Section

Kyoung, Kyu Sang; Cho, A Ra; Lee, Young Mi; Park, Min Ah; Jeong, Eun Hwan; Ji, Ill Woon

Abstract

OBJECTIVE
The purpose of this study was to determine the factors associated with successful vaginal birth after cesarean section (VBAC), and to analyze the causes of failed VBAC.
METHODS
This study was performed based on 193 pregnant women who tried vaginal delivery after cesarean section in Chungbuk National University Hospital from January 1997 to December 2005. Maternal age, gestational age, cervical dilatation at admisson, maternal body mass index (BMI), neonatal bodyweight, history of prior vaginal delivery, and indication of prior cesarean section were retrospectively analyzed between the successful group and the failed group of women who tried labor. The causes of the failed trial were analyzed.
RESULTS
Seventy nine percent (153/193) was successful in the trial of VBAC and 21% (40/193) failed. There were no difference in maternal age or gestational age between two groups. The success rate was significantly higher when cervical dilatation at admission was more extended, BMI of pregnant women before pregnancy and birth was lower, and birthweight of newborn was lower. Maternal request was the major cause of failure (47.5%), and others were failure to progress, non-reassuring fetal monitoring and failed induction.
CONCLUSION
The factors that had significant differences in this study can be used as predictor of successful VBAC. And failed trial of VBAC due to maternal request can be decreased by adequate explanation regarding the complication of emergency operation, and enough pain control during labor.