Factors affecting success of trial of labour afterprevious one lower segment Caesarean section


Objective: The aim was to analyze the different factors associated with successful trial of labor after previous one lower segment cesarean delivery in our institution.
Patients and methods: A Prospective case-series study was done at Al-Batool Maternity Teaching Hospital, Mosul on 476 women with previous one lower segment Caesarean delivery subjected to trial of labour between January 2009 and mid June 2009.
Results: Successful trial of labour and vaginal delivery was reported in 82%. The factors that were found to be significantly associated with successful trial of labour are: parity of 2-4, history of previous vaginal delivery and particularly history of vaginal birth after Caesarean, fetal malpresentation as the indication of previous Caesarean, inter-pregnancy interval longer than 12 months, gestational age ≤ 40 weeks, cervical dilation ≥4 cm, cervical effacement ≥50%, station lower than –1 and intact membrane at time of admission, clear liquor and neonatal weight < 4000 grams.
Conclusions: The factors present in woman's obstetric history and during her intrapartum course in the current pregnancy and birth weight that had significant differences in this study can be used as predictor of successful trial of labour and will help obstetrician to identify women who are more likely to attempt trial of labor and have a successful vaginal birth after previous one lower segment Caesarean delivery.

Keywords: Caesarean section, vaginal birth after Caesarean (VBAC), trial of labour after Caesarean delivery (TOL), prior Caesarean delivery.