Factors Associated with Success of VBAC in three teaching hospitals in Addis Ababa, Ethiopia: A case-control study

Abstract

Brief BackgroundVaginal delivery after previous one cesarean section for a non recurringindication has been described with many evidences as a safe practice and success rate of 60-80%.Hence many centers are offering VBAC for candidates leaving the century old dictum of oncecesarean always cesarean. But predicting success of VBAC after TOL is still a difficult problemwith lack of a validated tool of prediction world wide.Studies on predictors of success are fewand most of them conducted in developed countries and difficult to generalize. Thereforeassessing factors associated with successful VBAC is very important to counsel mothers onVBAC.ObjectiveTo assess demographic, past and present obstetric factors associated with successfulVBAC In three teaching HospitalsinA.AMethodsA casecontrol studywasconducted to compare the factors associated with successfulVBAC in teaching hospitals in Addis Ababa in one year period. The cases were thosesuccessfully delivered vaginally and the controlswerethose with failed VBAC and delivered byC/S. The sample sizewas101vaginal deliveries and the controls were 103 failed VBAC patientswhich made the case to control ratio of 1:1.In this study the factors associated with success ofVBAC wereprim parity, history of still birth, historyof successful VBAC in thepast, ruptureofmembrane at admission, cervical dilatation at admission, presenceof meconium and presence ofmalposition.Also 66 % of the failed VBAC patients had indications for the second C/S whichcould have been corrected by augmentation if there was no scar..