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Korean Journal of Obstetrics & Gynecology 2003;46(11):2209-2215.
Published online November 1, 2003.
A Study of Successful Prognostic Factors in Vaginal Birth after Cesarean Sections.
Jong Sik Park, Ki Yong Kim, Ki Hoon Na, Kwoan Young Oh, Mi Hye Park, Yun Seok Yang, In Taek Hwang, Joon Suk Park
1Department of Obstetrics and Gynecology, Eulji University Hospital, Daejeon, Korea.
2Department of Obstetrics and Gynecology, College of Medicine, Medical Research Center, Ewha Womans University, Seoul, Korea.
Abstract
OBJECTIVE
Recently, with rising rates of repeat cesarean sections, enormous amount of the studies about trial of labor after cesarean section have been reported to decrease the rate of cesarean section. The purpose of this study is to provide data regarding the safety and the successful prognostic factors of VBAC (vaginal birth after cesarean section). METHODS: This retrospective study was performed based on 194 pregnant women who tried vaginal delivery after cesarean section at Eulji University Hospital from March 1997 to February 2002. The age of mother, gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, and spontaneous labor were analyzed between successful group (177 patients) and failure group (17 patients) with trial of labor. Student T-test and Chi-square test were used for statistical analysis. RESULTS: 177 cases (91.24%) in 194 cases succeeded in VBAC and 17 cases (8.76%) failed. There was no maternal death or uterine rupture in the cases of trial of labor. The gestational age, estimated fetal body weight by ultrasonography, neonatal body weight, cervical effacement, cervical dilatation, Bishop score, the number of previous vaginal delivery, spontaneous labor had notable differences between the successful group and the failure group. But, There was no significant difference in maternal age. CONCLUSION: The trial of labor after cesarean section is relatively safe method of delivery if it is performed under strict indication. Above findings can be used as possible prognostic factors for the success of VBAC and may reduce the risk and complication of VBAC. The following studies with large populations and performed by multi-centers will be needed for the evaluation of safety and successful prognostic factors of VBAC.
Key Words: VBAC, Successful prognostics factors


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