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Vol 92, No 1 (2021)
Research paper
Published online: 2021-01-29
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Risk factors for unsuccessful vaginal birth after caesarean at full dilatation

Julia Zareba-Szczudlik1, Aneta Malinowska-Polubiec2, Agnieszka Dobrowolska-Redo2, Zbigniew Lewandowski3, Joanna Kacperczyk-Bartnik2, Pawel Bartnik2, Ewa Romejko-Wolniewicz2
DOI: 10.5603/GP.a2020.0140
·
Pubmed: 33576488
·
Ginekol Pol 2021;92(1):24-29.
Affiliations
  1. The Institute of Mother and Child, Warsaw, Poland
  2. 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw
  3. Department of Epidemiology, Medical University of Warsaw

open access

Vol 92, No 1 (2021)
ORIGINAL PAPERS Obstetrics
Published online: 2021-01-29

Abstract

Objectives: The purpose of this study was to determine the risk factors for caesarean sections in the second stage of labour after a previous caesarean section among women who underwent trial of labour (TOL). Material and methods: From a total of 639 women who experienced one caesarean section, 456 women were qualified for TOL. From this group, 105 women were subjected to a caesarean section in the first stage of labour and another 351 women reached the second stage of labour. From the latter group, 309 women delivered naturally and 42 were subjected to a caesarean section. Results: Risk factors for the necessity of performing a caesarean section in the second stage of labour after a previous caesarean section was the weight gain during pregnancy (OR = 1.07), the height of fundus uteri (OR = 1.25) before delivery, and the estimated foetal weight (OR = 1.01), a past delivery of a child with a birth weight exceeding 4.000 g (OR = 2.14), the presence of pre-gestational diabetes (OR = 15.4) and gestational diabetes (OR = 2.22), necessity of applying a delivery induction (OR = 2.52), stimulation of uterine activity during delivery (OR = 2.43) and application of epidural analgesia (OR = 4.04). A factor reducing the risk of a caesarean section in the second stage was a vaginal delivery in a woman’s history (OR = 0.21). Conclusions: Women should be encouraged to deliver naturally after a previous caesarean section, especially when their history includes a vaginal delivery and if there is no need for labour induction.

Abstract

Objectives: The purpose of this study was to determine the risk factors for caesarean sections in the second stage of labour after a previous caesarean section among women who underwent trial of labour (TOL). Material and methods: From a total of 639 women who experienced one caesarean section, 456 women were qualified for TOL. From this group, 105 women were subjected to a caesarean section in the first stage of labour and another 351 women reached the second stage of labour. From the latter group, 309 women delivered naturally and 42 were subjected to a caesarean section. Results: Risk factors for the necessity of performing a caesarean section in the second stage of labour after a previous caesarean section was the weight gain during pregnancy (OR = 1.07), the height of fundus uteri (OR = 1.25) before delivery, and the estimated foetal weight (OR = 1.01), a past delivery of a child with a birth weight exceeding 4.000 g (OR = 2.14), the presence of pre-gestational diabetes (OR = 15.4) and gestational diabetes (OR = 2.22), necessity of applying a delivery induction (OR = 2.52), stimulation of uterine activity during delivery (OR = 2.43) and application of epidural analgesia (OR = 4.04). A factor reducing the risk of a caesarean section in the second stage was a vaginal delivery in a woman’s history (OR = 0.21). Conclusions: Women should be encouraged to deliver naturally after a previous caesarean section, especially when their history includes a vaginal delivery and if there is no need for labour induction.

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Keywords

caesarean section; repeat; trial of labour; vaginal birth after caesarean

About this article
Title

Risk factors for unsuccessful vaginal birth after caesarean at full dilatation

Journal

Ginekologia Polska

Issue

Vol 92, No 1 (2021)

Article type

Research paper

Pages

24-29

Published online

2021-01-29

Page views

1086

Article views/downloads

993

DOI

10.5603/GP.a2020.0140

Pubmed

33576488

Bibliographic record

Ginekol Pol 2021;92(1):24-29.

Keywords

caesarean section
repeat
trial of labour
vaginal birth after caesarean

Authors

Julia Zareba-Szczudlik
Aneta Malinowska-Polubiec
Agnieszka Dobrowolska-Redo
Zbigniew Lewandowski
Joanna Kacperczyk-Bartnik
Pawel Bartnik
Ewa Romejko-Wolniewicz

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