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Factors associated with vaginal birth after cesarean in a maternity hospital of Rio de Janeiro
1Rua Liberato Carioni 406, Lagoa da Conceição CEP 88062220, SC, Florianópolis, Brazil. edorsi@uol.com.br
Objectives:
Identifying characteristics associated with vaginal birth after cesarean.
Study Design:
Case-control study based on medical records.
Study Population:
women with previous cesarean, who had delivered in a public Rio de Janeiro maternity hospital between 1992 and 1996.
Sample:
141 cases (vaginal births after cesarean) and 304 controls (a new cesarean after other(s)). Multivariate analysis with logistic regression was carried out.
Results:
The following characteristics were associated with greater probability of vaginal birth (IC=95%): only one previous cesarean (OR=19.05; IC=6.88-52.76); cervical dilatation at admission above 3 cm (OR=8.86; IC=4.93-15.94); gestational age below 37 weeks (OR=3.01; IC=1.40-6.46); history of at least one previous vaginal birth (OR=2.12; IC=1.18-3.82); level of education below high school (OR=1.94; IC=1.02-3.69). Chronic hypertension reduced the chances of vaginal birth (OR=0.44; IC=0.22-0.88).
Conclusions:
Among the factors that can be modified to reduce the number of repeated cesareans are: trial of labor promotion, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy.
Condensation:
Among the factors that can be modified to reduce the number of repeated cesareans are: the trial of labor promotion for women who present previous cesarean, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy.