IMR Press / CEOG / Volume 48 / Issue 3 / DOI: 10.31083/j.ceog.2021.03.2439
Open Access Original Research
Do women in Slovenia prefer vaginal birth after prior caesarean and what hinders its successful outcome? A single institution retrospective analysis
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1 Department of Perinatology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
2 Department of Gynecology and Obstetrics, Faculty of Medicine University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
3 Division of Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
Clin. Exp. Obstet. Gynecol. 2021 , 48(3), 607–614; https://doi.org/10.31083/j.ceog.2021.03.2439
Submitted: 30 December 2020 | Revised: 27 January 2021 | Accepted: 4 February 2021 | Published: 15 June 2021
(This article belongs to the Special Issue Caesarean Section Today - “Caesarology in the 21st Century”)
Abstract

Background: To analyze the mode of delivery and the outcome of a trial of labor in women with one prior caesarean birth. Methods: We extracted from the national database our hospital’s information on women with a prior caesarean section from January 2014 to July 2019. They were then divided into groups that either opted for a trial of labor or repeat caesarean section. We further focused on the trial of labor group and divided them in two subgroups of either a vaginal delivery or repeat caesarean section. Results: 796 women with one prior caesarean section were identified and 201 (25.3%) opted for a trial of labor. Successful vaginal delivery was achieved in 84.1% of women that opted for a trial of labor. Women pregnant for the third time or greater delivered vaginally at a higher rate (24.3% vs 10.7%). More women who had labor induced with a Foley catheter ended in caesarean section (8.1% vs 17.9%). There was one uterine rupture without further complications. Failed trial of labor was caused by the lack of persistence (14.3%) and arrest of labor (50.0%). Conclusion: Improved counselling is needed for those women who choose a trial of labor. The rate of successful vaginal delivery following a trail of labor is high, but could be improved with more conservative management during the first stage of labor.

Keywords
Vaginal birth after a cesarean section
Trial of labor
Repeat caesarean delivery
Birth outcomes
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