Maternal and obstetrical factors associated with a successful trial of vaginal birth after cesarean section

Objective: to detect the maternal and obstetrical factors associated with successful trial of vaginal birth among women with a previous cesar­ean delivery.material and methods: a total of 122 women who were eligible for a trial of labor after cesarean section (tolac) according to departmental protocol were included in this comparative prospective study. after informed consent,the women included in this study were subjected to a thorough history to detect maternal and obstetric characteristics and a standard examination to estimate fetal weight,engagement of the fetal head,intra-partum features of fetal membranes,and cervical dilatation. after delivery,data on duration of labor,labor augmentation,mode of delivery,birth outcome,and neonatal intensive care (nicu) admission were recorded and analyzed.results: trial of labor after cesarean section was successful in 72.13% and was unsuccessful in 27.87%. body mass index (bmi) was significantly lower in the successful tolac group compared to the unsuccessful group (23.8±0.03 versus 26.2±0.02 kg/m2),and the number of women with bmi >25 kg/m2 was significantly high in the unsuccessful group; also,mean gestational age was significantly lower in the successful tolac group compared to the unsuccessful group (37.5±0.04 versus 38.5±0.03 weeks),and the number of women admitted in labor with gestation ≥40 weeks was significantly high in the unsuccessful group. the number of women admitted with >2/5 of fetal head palpable abdominally and fetal head station ≥-2 was significantly high in the unsuccessful tolac group.conclusion: in carefully selected cases,tolac is safe and often successful. presence of bmi >25 kg/m2,gestation ≥40 weeks,and vertex sta­tion ≥-2 were risk factors for unsuccessful tolac. © 2014 by the turkish-german gynecological education and research foundation.