A retrospective analysis of the Vaginal Birth After Cesarean Section rate and indications in the UAE

With the increasing incidence of cesarean sections, the importance of VBAC cannot be overstated, as it may reduce repeat cesarean sections. This audit aimed to evaluate the number of patients who underwent trial of labor after cesarean (TOLAC), the percentage who achieved VBAC, and the percentage who underwent emergency cesarean following TOLAC. The audit was carried out at Burjeel Medical City, Abu Dhabi, UAE, on women with a single previous lower-segment cesarean.We retrospectively collected data from medical records for the period from January to December 2024 for analysis. Women with a single previous lower-segment cesarean and pregnancy of ≥37 weeks’ gestation were included in the study. Women with a contraindication to vaginal birth detected in their current pregnancy were not recommended for TOLAC and were included in the ERCS group. We analyzed data descriptively, with 95% CIs calculated using the Wilson score method.Of 128 eligible women, 56 (43.8%; 95% CI 35.5–52.4%) underwent TOLAC and 72 (56.3%; 95% CI 47.6–64.5%) underwent ERCS. Of those who underwent TOLAC, 43 achieved VBAC (76.8%; 95% CI 64.2–85.9%) and 13 (23.2%; 95% CI 14.1–35.8%) required emergency cesarean delivery. Documented reasons for unsuccessful TOLAC included scar tenderness, labor not progressing, and failed induction of labor.In this single-center audit, the VBAC success rate was within the range reported in international guidelines and the published literature. These data are purely descriptive, as this study did not include a prediction model for VBAC success or safety outcomes. It seems that VBAC is a viable mode of delivery among properly selected women with a single previous lower segment cesarean.