Cervical dilatation at the time of cesarean section may affect the success of a subsequent vaginal delivery

J Matern Fetal Neonatal Med. 2009 Nov;22(11):1057-62. doi: 10.3109/14767050902874089.

Abstract

Objective: To evaluate the effect of labor progress prior to cesarean delivery on the outcome of vaginal birth after cesarean delivery (VBAC).

Methods: The medical records of women attempting VBAC between January 2000 and February 2008 were reviewed. All women had only one previous cesarean and underwent spontaneous labor.

Results: Among 1148 enrolled women, 956 (83.3%) achieved a successful VBAC. Birth weight, previous indication for cesarean delivery and oxytocin augmentation were significantly associated with VBAC outcome. By multivariate analysis, a cervical dilatation >or=8 cm at previous cesarean was independently predictive of successful VBAC in women with a previous cesarean for non-recurrent indications (p = 0.046), yielding a VBAC success rate of 93.1%, whereas the extent of cervical dilatation at the previous cesarean did not affect the outcome of subsequent delivery in women with a previous cesarean for recurrent indications.

Conclusions: Women with cesarean for non-recurrent indications who achieved a cervical dilatation >or=8 cm may be the best candidates for VBAC, with the greatest likelihood of a successful VBAC. Labor progress at previous cesarean can serve as a valuable indicator for VBAC outcome in women with a previous cesarean for non-recurrent indications, and therefore should be discussed as part of preconception counseling.

MeSH terms

  • Adult
  • Birth Weight
  • Cesarean Section*
  • Female
  • Humans
  • Infant, Newborn
  • Labor Stage, First*
  • Labor, Induced / statistics & numerical data
  • Pregnancy
  • Trial of Labor
  • Vaginal Birth after Cesarean / statistics & numerical data*