Do women in Slovenia prefer vaginal birth after prior caesarean and what hinders its successful outcome? A single institution retrospective analysis

Abstract

Do women in Slovenia prefer vaginal birth after prior caesarean and what hinders its successful outcome? A single institution retrospective analysis Faris Mujezinović1,2, *, Veronika Anzeljc1 , Monika Sobočan2,3 , Iztok Takač2,3 1Department of Perinatology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia 2Department of Gynecology and Obstetrics, Faculty of Medicine University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia 3Division of Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia *Correspondence: faris.mujezinovic@ukc-mb.si (Faris Mujezinović) DOI:10.31083/j.ceog.2021.03.2439 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 30 December 2020 Revised: 27 January 2021 Accepted: 4 February 2021 Published: 15 June 2021 Background: To analyze the mode of delivery and the outcome of a trial of labor in women with one prior caesarean birth. Methods: We extracted from the national database our hospital's information on women with a prior caesarean section from January 2014 to July 2019. They were then divided into groups that either opted for a trial of labor or repeat caesarean section. We further focused on the trial of labor group and divided them in two subgroups of either a vaginal delivery or repeat caesarean section. Results: 796 women with one prior caesarean section were identified and 201 (25.3%) opted for a trial of labor. Successful vaginal delivery was achieved in 84.1% of women that opted for a trial of labor. Women pregnant for the third time or greater delivered vaginally at a higher rate (24.3% vs 10.7%). More women who had labor induced with a Foley catheter ended in caesarean section (8.1% vs 17.9%). There was one uterine rupture without further complications. Failed trial of labor was caused by the lack of persistence (14.3%) and arrest of labor (50.0%). Conclusion: Improved counselling is needed for those women who choose a trial of labor. The rate of successful vaginal delivery following a trail of labor is high, but could be improved with more conservative management during the first stage of labor. Keywords Vaginal birth after a cesarean section; Trial of labor; Repeat caesarean delivery; Birth outcomes