Akademik Veri Yönetim Sistemi
Jinekoloji ve Obstetrik Dergisi, cilt.18, sa.4, ss.236-240, 2004 (Scopus, TRDizin)
OBJECTIVE: To evaluate the results of vaginal birth after cesarean (VBAC) and examine the risk of uterine rupture in women with one previous cesarean delivery. STUDY DESIGN: The medical records of all pregnant women with a history of one cesarean delivery during 5-year period in our clinic were reviewed. Information was collected about demographics, obstetric history, neonatal birth weight and Apgar scores, the rates of uterine rupture and treatment of the pregnancy. The women were divided into elected repeat cesarean delivery (n=476) and trial of VBAC groups (n=285). Then, the patients in VBAC group were divided into two subgroups; successful VBAC (n=192) and failed VBAC (n=93). A comparison of outcomes was performed those groups. RESULTS: There were 761 women with a history of one previous cesarean delivery during the study period. The attempted VBAC rates were 16%, 17.8%, 23.5%, 46.9 % and 49% in between 1999-2003 years, respectively. The overall trial of VBAC rate was 37.5%, of which 67.4 % were successful. Uterine rupture was detected in 4 cases in the VBAC group, and in 7 cases in the elective cesarean group (p>0.5). The 5-min Apgar scores, and birth weights were similar in both groups (p>0.5). The detected uterine rupture cases in VBAC group were observed only failed VBAC subgroup (p<0.01), and fetal death occurred only 1 case in this group. The birth weights of failed VBAC group were higher than successful VBAC group (p<0.05). CONCLUSION: With high success rate of the trial of VBAC is a safe alternative to elective repeat cesarean. The success rate may be increased with the carefully selected patient for trial of VBAC. But, it is not a risk free method. This approach must be certainly done in center that has condition for emergency cesarean delivery.