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KMID : 0361720070180040385
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Korean Journal of perinatology
2007 Volume.18 No. 4 p.385 ~ p.390
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A Study of Causes and Predictive Factors in Failed Vaginal Birth After Cesarean Section
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Kyoung Kyu-Sang
Cho A-Ra
Lee Young-Mi
Park Min-Ah
Jeong Eun-Hwan
Ji Il-Woon
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Abstract
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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 successful group and failed group of women who tried labor. The causes of failed trial were analyzed.
Results: Seventy nine percent (153/193) was successful in trial of VBAC and 21%(40/193) failed. There was no difference in maternal age or gestational age between two groups. The success rate was significantly higher when cervical dilatation at admission is more extended, BMI of pregnant women before pregnancy and birth is lower, and birthweight of newborn is 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 complication of emergency operation, and enough pain control during labor.
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KEYWORD
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VBAC, Maternal request, Predictor, Pain control
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