Clinical Results of Vaginal Birth after Cesarean_West China Medical Journal

Authors：

 ZHOUChun-hong

Delivery Room, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P. R. China;

Corresponding author：

Keywords：

Cesarean; Vaginal birth; Arrested labor

DOI：

10.7507/1002-0179.20140702

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Objective To investigate the factors affecting the results of vaginal birth after cesarean (VBAC). Methods We retrospectively analyzed the data from 80 pregnant women of prior cesarean section with intention of vaginal delivery between October 2012 and July 2013. According to the final way of delivery, the 80 women were divided into two groups, the VBAC group (40 cases) and repeated cesarean section (RCS) group (40 cases). The clinical characteristics of the two groups were compared and further multi-variant analysis was conducted. Besides, 40 women with successful repeated vaginal delivery were included as controls. The delivery time and bleeding volume were compared between the VBAC group and the control group. Results The three determinant factors associated with the present VBAC were: Arrested labor as the indication of prior cesarean section [OR=1.601, 95%CI (1.025, 2.469), P=0.04], Bishop Score [OR=3.757, 95%CI (1.437, 8.772), P=0.01] and infant weight [OR=1.391, 95%CI (1.124, 2.583), P=0.03]. The VBAC group presented a higher Episiotomy rate than the RCS group. No significant difference was found between the VBAC and the control group regarding the delivery time [(6.71±2.94) vs. (5.88±2.47) hours, P=0.176] and bleeding volume [(259.13± 75.31) vs. (230.36±67.44) mL, P=0.076]. Conclusion VBAC presents a better and faster recovery with a shorter hospital stay. But the indication of VBAC should be strictly followed to ensure the safety of both mothers and babies.

Citation： ZHOUChun-hong. Clinical Results of Vaginal Birth after Cesarean. West China Medical Journal, 2014, 29(12): 2322-2325. doi: 10.7507/1002-0179.20140702 Copy

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2.	Kayani SI, Alfirevic Z. Uterine rupture after induction of labour in women with previous caesarean section[J]. BJOG, 2005, 112(4):451-455.
3.	Barber EL, Lundsberg LS, Belanger K, et al. Indications contributing to the increasing cesarean delivery rate[J]. Obstet Gynecol, 2011, 118(1):29-38.
4.	Yap OW, Kim ES, Laros RK. Maternal and neonatal outcomes after uterine rupture in labor[J]. Am J Obstet Gynecol, 2001, 184(7):1576-1581.
5.	陈灵红, 段岸滨, 毛雅萍. 孕妇学校健康教育效果评价与分析[J]. 中国妇幼保健, 2009, 24(32):4509-4510.
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8.	Cahill AG, Stamilio DM, Ao, et al. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery?[J]. Am J Obstet Gynecol, 2006, 195(4):1143-1147.
9.	陈廉, 张潇潇. 瘢痕子宫妊娠分娩时机及分娩方式选择[J]. 中国实用妇科与产科杂志, 2010, 26(8):594-596.
10.	Guise JM, Denman MA, Emeis C, et al. Vaginal birth after cesarean:new insights on maternal and neonatal outcomes[J]. Obstet Gynecol, 2010, 115(6):1267-1278.
11.	Matias JP, Parpinelli MA, Cecatti JG. Factors associated with mode of delivery among primipara women with one previous cesarean section and undergoing a trial of labor[J]. Rev Assoc Med Bras, 2007, 53(2):109-115.
12.	Schoorel EN, Van Kuijk SM, Melman S, et al. Vaginal birth after a caesarean section:the development of a Western European population-based prediction model for deliveries at term[J]. BJOG, 2014, 121(2):194-201.
13.	Chaillet N, Bujold E, Dubé E, et al. Validation of a prediction model for vaginal birth after caesarean[J]. J Obstet Gynaecol Can, 2013, 35(2):119-124.
14.	Costantine MM, Fox K, Byers BD, et al. Validation of the prediction model for success of vaginal birth after cesarean delivery[J]. Obstet Gynecol, 2009, 114(5):1029-1033.
15.	Chilaka VN, Cole MY, Habayeb OM, et al. Risk of uterine rupture following induction of labour in women with a previous caesarean section in a large UK teaching hospital[J]. J Obstet Gynaecol, 2004, 24(3):264-265.
16.	Locatelli A, Regalia AL, Ghidini A, et al. Risks of induction of labour in women with a uterine scar from previous low transverse caesarean section[J]. BJOG, 2004, 111(12):1394-1399.
17.	Zelop CM, Shipp TD, Repke JT, et al. Uterine rupture during induced or augmented labor in gravid women with one prior cesarean delivery[J]. Am J Obstet Gynecol, 1999, 181(4):882-886.
18.	肖碧辉. 瘢痕子宫再次妊娠阴道分娩的观察与护理[J]. 临床合理用药杂志, 2012, 5(22):167.

1. Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia:the WHO global survey on maternal and perinatal health 2007-08[J]. Lancet, 2010, 375(9713):490-499.
2. Kayani SI, Alfirevic Z. Uterine rupture after induction of labour in women with previous caesarean section[J]. BJOG, 2005, 112(4):451-455.
3. Barber EL, Lundsberg LS, Belanger K, et al. Indications contributing to the increasing cesarean delivery rate[J]. Obstet Gynecol, 2011, 118(1):29-38.
4. Yap OW, Kim ES, Laros RK. Maternal and neonatal outcomes after uterine rupture in labor[J]. Am J Obstet Gynecol, 2001, 184(7):1576-1581.
5. 陈灵红, 段岸滨, 毛雅萍. 孕妇学校健康教育效果评价与分析[J]. 中国妇幼保健, 2009, 24(32):4509-4510.
6. Carlson S, Aupperle P. Nutrient requirements and fetal development:recommendations for best outcomes[J]. J Fam Pract, 2007, 56(11 Suppl Womens):S1-S6.
7. Macones GA, Peipert J, Nelson DB, et al. Maternal complications with vaginal birth after cesarean delivery:a multicenter study[J]. Am J Obstet Gynecol, 2005, 193(5):1656-1662.
8. Cahill AG, Stamilio DM, Ao, et al. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery?[J]. Am J Obstet Gynecol, 2006, 195(4):1143-1147.
9. 陈廉, 张潇潇. 瘢痕子宫妊娠分娩时机及分娩方式选择[J]. 中国实用妇科与产科杂志, 2010, 26(8):594-596.
10. Guise JM, Denman MA, Emeis C, et al. Vaginal birth after cesarean:new insights on maternal and neonatal outcomes[J]. Obstet Gynecol, 2010, 115(6):1267-1278.
11. Matias JP, Parpinelli MA, Cecatti JG. Factors associated with mode of delivery among primipara women with one previous cesarean section and undergoing a trial of labor[J]. Rev Assoc Med Bras, 2007, 53(2):109-115.
12. Schoorel EN, Van Kuijk SM, Melman S, et al. Vaginal birth after a caesarean section:the development of a Western European population-based prediction model for deliveries at term[J]. BJOG, 2014, 121(2):194-201.
13. Chaillet N, Bujold E, Dubé E, et al. Validation of a prediction model for vaginal birth after caesarean[J]. J Obstet Gynaecol Can, 2013, 35(2):119-124.
14. Costantine MM, Fox K, Byers BD, et al. Validation of the prediction model for success of vaginal birth after cesarean delivery[J]. Obstet Gynecol, 2009, 114(5):1029-1033.
15. Chilaka VN, Cole MY, Habayeb OM, et al. Risk of uterine rupture following induction of labour in women with a previous caesarean section in a large UK teaching hospital[J]. J Obstet Gynaecol, 2004, 24(3):264-265.
16. Locatelli A, Regalia AL, Ghidini A, et al. Risks of induction of labour in women with a uterine scar from previous low transverse caesarean section[J]. BJOG, 2004, 111(12):1394-1399.
17. Zelop CM, Shipp TD, Repke JT, et al. Uterine rupture during induced or augmented labor in gravid women with one prior cesarean delivery[J]. Am J Obstet Gynecol, 1999, 181(4):882-886.
18. 肖碧辉. 瘢痕子宫再次妊娠阴道分娩的观察与护理[J]. 临床合理用药杂志, 2012, 5(22):167.

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