Vol. 8, Issue 7 (2019)

Objective: Our purpose was to determine the maternal risks associated with failed attempt at vaginal birth after cesarean compared with elective repeat cesarean delivery or successful vaginal birth after cesarean.

Study Design: its prospective study done in Al-Zahra Teaching Hospital in Najaf city from December 2010 to October 2011. The following three groups were defined: women who had successful vaginal birth after cesarean, women who had failed vaginal birth after cesarean and women who underwent elective repeat cesarean. Predictor variables included age, parity, reasons for repeat cesarean delivery, gestational age. Outcome variables included uterine rupture or dehiscence, hemorrhage, need for transfusion, The Student t test and the x2 test were used to compare categorical variables and means; maternal complications and factors associated with successful vaginal birth after cesarean were analyzed with multivariate logistic regression, allowing odds ratios, adjusted odds ratios, 95% confidence intervals, and P values to be calculated.

Results: A total of 226 patients were delivered during the study period, which had previously cesarean delivery. Repeat cesarean deliveries were performed in 168 (74.3%) women and 58 (25.6%) successful vaginal births after cesarean delivery occurred. Vaginal birth after cesarean was attempted by 113 patients or 50% of all appropriate candidates. Vaginal birth after cesarean was successful in 58 women (25.6%) and unsuccessful in 55(24.3%) women. Multiple gestations were excluded from analysis. The rate of scar dehiscence was (3.5%) of all women attempting labor; the rate of true rupture was 0.8%; and there was no hysterectomy and postpartum heamorrhege was 5 women (4.4%), women who experienced failed vaginal births after cesarean had a rate of uterine rupture that was 0.8%, a rate of transfusion that was 9 %, postpartum heamorrhege was (9%)