[The impact of some factors on obstetrical management in women with previous cesarean section]

Considering obstetrical management we should have always in mind advantages and disadvantages of vaginal birth after cesarean (VBAC) and elective cesarean section after a previous one, financial part of the elected mode of delivery in the particular case, psychological aspect of the matter (especially after an unsuccessful trial of labour--TOL) and not on the last position-patient's right to choose the way how to deliver. We performed an inquiry of 3-year-period and 50 women with a prior cesarean section, by which we studied the factors contributed in different extent to the choice of the following approach to delivery: patient's preliminary choice, the impact of medical staff during pregnancy and when entering the Department of Obstetrics, the impact of non-medical persons, complications after the previous cesarean section, patient's acquaintance with complications and consequences associated with the operative mode of delivery, as well as doctor's personal attitude to the different modes of delivery. The aim of our research is to show that by careful selection (according to the established indices) of women, who have a high probability (more than 80%) to deliver their babies vaginally and offering adequate information by educational literature and including the woman in the decision making process, the growing rate of cesarean section will be decreased by increasing the number of VBAC--undoubtedly one of the most important issue in modern obstetrics.