Five Year Retrospective Review of the Success of Vaginal Birth After
Cesarean Section (VBAC) based on Previous Cesarean Delivery Indication
in a Tertiary University Hospital
Abstract
OBJECTIVE: This study aims to determine the success of vaginal birth
after cesarean section (VBAC) based on previous cesarean delivery
indication. DESIGN: Retrospective cohort study SETTING: University of
the Philippines - Philippine General Hospital, Department of Obstetrics
and Gynecology hospital masterlist data SAMPLE: Gravidas with a previous
cesarean section within a five year period (2015 - 2019) METHODS:
Maternal demographics, obstetric characteristics on admission, perinatal
morbidities and maternal morbidities were recorded. Data was analyzed
using Student’s t-test for continuous variables, chi-square test to
compare the distribution and Z-test was used to compare success rates.
MAIN OUTCOME MEASURES: The main outcome measures are TOLAC rate, VBAC
rate, factors which affect success of TOLAC and VBAC, and perinatal and
maternal morbidities associated with successful and failed VBAC.
RESULTS: A total of 2485 patients were included. The overall TOLAC rate
was 17% (95% CI: 15.6% - 18.6%) and the VBAC rate was 9.5% (95%
CI: 8.3% - 10.7%). Patients with successful VBAC are younger, had less
weight and body mass index, shorter interdelivery intervals, and
admitted in active phase cervical dilatation. Previous cesarean section
indication did not significantly affect VBAC success. Perinatal and
maternal morbidities of successful and failed VBAC did not significantly
differ from one another. CONCLUSIONS: This study provided local evidence
and valuable perspective in success factors which influence our
counselling and eventual management of patients with a previous cesarean
section.