The Obstetrics Outcomes of Vaginal Birth After Cesarean Section in a Cohort with High Induction of Labor Rate

Objective: Our primary objective is to evaluate the short-term maternal and perinatal results associated with the mode of delivery after cesarean section (CS). A second objective is to investigate the factors governing the success of trial of labor after cesarean (TOLAC). Material and Methods: In this retrospective cohort study, 126 singleton cephalic deliveries of women who had a history of one CS delivery were analyzed. The patients were divided into two groups: those who underwent TOLAC (n=31) and those who underwent elective repeat cesarean section (n=95). Delivery data, demographics, obstetric and medical history, intrapartum events, and maternal and perinatal outcomes were assessed. Results: The rate of successful vaginal birth after cesarean among the women who chose TOLAC was 64.5%. The groups were similar to each other with regard to maternal and perinatal complications. According to the current pregnancy characteristics of the patients with successful and failed vaginal delivery attempts; there were statistically significant differences between the groups in terms of Bishop scores and birth weights. The Bishop scores were higher in the successful TOLAC group (3.5 vs. 1; p=0.001). However, the birth weights were lower in the successful TOLAC group (3393 +/- 395 vs. 3708 +/- 430; p=0.049). The rate of spontaneous labor was higher in the successful TOLAC group, although it did not reach statistical significance. Conclusion: TOLAC is a farily safe procedure for selected pregnant women with one previous cesarean sections. It should be offered to all suitable pregnant women in order to reduce high CS rate and prevent complication associated with higher order repeat cesarean.