Rate, Precautions, and Outcome of Vaginal Birth after Caesarean Section in Beni-Suef Governorate

Background: Almost a third of all deliveries now involve a caesarean section (CS). Trial of labor after caesarean (TOLAC) followed by vaginal birth after caesarean (VBAC) is crucial for lowering the total caesarean rate since repeat caesarean is the most prevalent single rationale for caesarean. Aim: this study was conducted to assess the incidence, and maternal and neonatal outcomes of vaginal birth after caesarean section. Methods: This retrospective cohort study was conducted at the obstetrics and gynecology department in of Beni-Suef General Hospital. The data was obtained from the files of each patient. The collected data included reported history taking, clinical examinations, preoperative and postoperative investigations, details of previous deliveries, and maternal and fetal outcomes of vaginal delivery following caesarean section. The success rate of TOLAC was (84.9%) while the failure rate was (15.1%). Results: The rate of succeeded VBAC was (1.6%) while the rate of CS was (38 %) from all deliveries in 2016 and 2017. There was a difference between succeeded VBAC group and failed group regarding the history of previous vaginal delivery, number, causes, type, indications of prior CS(s), duration between CS and current pregnancy, presentation, medical disorders, fetal heart rate (FHR), Apgar score and need for neonatal intensive care unit (NICU) admission. Conclusion: Regarding VBAC precautions, factors that improve success are previous lower segment CS, previous vaginal delivery, cephalic presentation, a single full-term fetus of average weight, good maternal health (free of medical disorder), the patient is in an active phase of the first stage of labor and previous vaginal delivery. VBAC became one of the solutions to avoid the complications of ERCD as there are fewer complications, shorter hospital stays, faster recovery, avoidance of major surgery, and reduced risk of NICU admission