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Vaginal delivery after one cesarean section
W A van der Walt1, H S Cronjé, R H Bam
1Department of Obstetrics and Gynecology, University of the Orange Free State, Bloemfontein, South Africa.
Summary
Vaginal birth after cesarean section was successful in 44.9% of cases in a South African hospital. While less frequent than in developed nations, attempting vaginal birth after cesarean section proved safe for mothers and infants.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Reproductive Medicine
Background:
- Cesarean section rates have increased globally.
- Vaginal birth after cesarean section (VBAC) is a debated topic.
- Limited data exists for VBAC in developing communities.
Purpose of the Study:
- To assess the success rate of VBAC.
- To evaluate the safety of VBAC.
- To understand VBAC outcomes in a South African teaching hospital.
Main Methods:
- A prospective study of 189 women with one prior cesarean section.
- Maternal morbidity analysis in 92 women with term infants (≥2500g).
- Data collected over a 10.5-month period.
Main Results:
- VBAC success rate was 44.9% (85/189).
- 34.4% had a cesarean during labor, 20.6% had elective cesareans.
- Maternal morbidity was 10.9% in the subgroup; 1 maternal and 2 perinatal deaths occurred.
Conclusions:
- VBAC occurred less frequently compared to developed countries.
- VBAC was found to be a safe procedure in this setting.
- Findings highlight the need for tailored VBAC protocols in developing regions.