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[Factors predicting outcome of trial of labor after prior cesarean section in a developing country]
E O Adjahoto1, D K Ekouevi, K A Hodonou
1Département de Gynécologie-Obstétrique, CHU-Tokoin, Lomé, Togo. adjahoto@hotmail.com
Objective:
To determine factors predictive of the outcome of trial of labor after cesarean section in women living in developing countries.
Material:
and methods. A retrospective study of 313 cases of trial of labor was conducted in patients with a history of at least one prior cesarean section. Multiple logistic regression was used to identify predictive factors. The adjusted odds ratios with 95% confidence intervals (95%CI) were used to indicate risk of failure of the trial of labor when the factor was present.
Results:
The rate of vaginal birth was 71.6%. Factors significantly predictive of failure of trial of labor were birth weight>3000 g (OR=2.68; 95%CI: 1.57-4.57), no previous vaginal delivery (OR=1.71; 95%CI: 1.26-3.76) and maternal age>28 years (OR=1.71; 95%CI: 1.01-2.90).
Conclusion:
Trial of labor should be proposed in most women with one previous cesarean section. A prior history of vaginal delivery is the best predictor of the positive outcome of trial of labor.