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[Vaginal delivery following cesarean section].

F W Jansen, J van Roosmalen, M J Keirse

    Nederlands Tijdschrift Voor Geneeskunde
    |April 1, 1989
    PubMed
    Summary

    Trial of labour after a previous caesarean section is safe and effective. Vaginal delivery is successful in 83% of women, even after caesarean for cephalopelvic disproportion.

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    Area of Science:

    • Obstetrics
    • Maternal-Fetal Medicine
    • Reproductive Health

    Context:

    • Analysis of labor outcomes in women with prior cesarean delivery.
    • Study period: 1977-1986 at Leiden University Hospital.
    • Inclusion of 462 women with previous cesarean sections.

    Purpose:

    • To evaluate the safety and success rates of trial of labor (TOL) after cesarean delivery.
    • To determine the influence of prior cesarean indication on subsequent labor outcomes.
    • To assess the predictive value of fetal weight estimation for TOL success.

    Summary:

    • Vaginal delivery was achieved in 83% of women undergoing a trial of labor after a previous cesarean section.
    • Trial of labor success was highest for women with prior breech presentation cesarean.
    • Even with prior cephalopelvic disproportion or failure to progress, TOL resulted in vaginal delivery for 65% of women.
    • Ultrasound fetal weight estimation did not predict TOL outcomes.

    Impact:

    • Supports the safety and rationality of attempting vaginal birth after cesarean (VBAC).
    • Provides evidence for informed decision-making regarding TOL in women with specific prior cesarean indications.
    • Highlights the importance of considering TOL as a viable option for a significant proportion of women with previous cesarean deliveries.

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