Vaginal Birth After Cesarean Section at Maharat Nakhon Ratchasima Hospital

Abstract

Over the past 10 years, the rates of cesarean section have marked risen and become a major concern. Because the large proportion performed are routine repeat operations, the rate could be reduced dramatically if a trial of labor were allowed routinely. A 5-years retrospective study from January 1, 1993 to December 31, 1997 was performed to study the success, costs and safety of vaginal birth after cesarean delivery (109 women) compare with those 436 women deliveried by routine repeat operations. An overall successful vaginal delivery rate is 92.66%. Twenty-six percent received oxytocin. No uterine rupture occur in this study. There were no differences in measures of maternal morbidity, except for a higher incidence of post partum hemorrhage and lower incidence of post partum fever. The cesarean women have higher costs and more length of hospitalization. The infants born vaginally have higher incidence of birth trauma and less mean birth weight than those born abdominally. There were no differences in the incidence of low Apgar scores, large for gestational age and low birth weight. We conclude that vaginal birth after cesarean delivery can be performed safely with no increased maternal or neonatal morbidity or mortality.