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Five Year Retrospective Review of the Success of Vaginal Birth After Cesarean Section (VBAC) based on Previous Cesarean Delivery Indication in a Tertiary University Hospital
  • John Edward Tanchuco,
  • Chiaoling Sua Lao
John Edward Tanchuco
Philippine General Hospital
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Chiaoling Sua Lao
Philippine General Hospital
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Abstract

OBJECTIVE: This study aims to determine the success of vaginal birth after cesarean section (VBAC) based on previous cesarean delivery indication. DESIGN: Retrospective cohort study SETTING: University of the Philippines - Philippine General Hospital, Department of Obstetrics and Gynecology hospital masterlist data SAMPLE: Gravidas with a previous cesarean section within a five year period (2015 - 2019) METHODS: Maternal demographics, obstetric characteristics on admission, perinatal morbidities and maternal morbidities were recorded. Data was analyzed using Student’s t-test for continuous variables, chi-square test to compare the distribution and Z-test was used to compare success rates. MAIN OUTCOME MEASURES: The main outcome measures are TOLAC rate, VBAC rate, factors which affect success of TOLAC and VBAC, and perinatal and maternal morbidities associated with successful and failed VBAC. RESULTS: A total of 2485 patients were included. The overall TOLAC rate was 17% (95% CI: 15.6% - 18.6%) and the VBAC rate was 9.5% (95% CI: 8.3% - 10.7%). Patients with successful VBAC are younger, had less weight and body mass index, shorter interdelivery intervals, and admitted in active phase cervical dilatation. Previous cesarean section indication did not significantly affect VBAC success. Perinatal and maternal morbidities of successful and failed VBAC did not significantly differ from one another. CONCLUSIONS: This study provided local evidence and valuable perspective in success factors which influence our counselling and eventual management of patients with a previous cesarean section.