Abstract

Ikechebelu J.I, Mbamara S.U and Afuba A.N.

This study was carried out to determine the incidence, predictive factors, and the outcome of the practice of vaginal birth after one previous caesarean section at Nnamdi Azikiwe University Teaching Hospital, Nnewi Southeast Nigeria. Data was retrieved from case records of patients who underwent trial of vaginal birth after caesarean section from January 2001 to December 2005. There were 2062 deliveries out of which 379 were caesarean sections thereby giving a caesarean section rate of 18.4%. A total of 105 patients had trial of vaginal birth after one previous caesarean section and 56 (53.3%) ended in repeat caesarean section while 49 (46.7%) had successful vaginal birth. The indications for the repeat caesarean section include poor progress in labour (43.1%), fetal distress (17.2%) and scar dehiscence/ruptured uterus (10.4%). Spontaneous onset of labour (56.0%), patient age of between 25-29 (51.6%), low social class (57.90%) and non recurrent indication in the previous caesarean section like malpresentation (62.5%) were the factors with positive predictive value on the out-come of trial of vaginal birth after one previous caesarean section. There was poor outcome in women above 35 years and higher (44% vs 20%) success rate among women who went into spontaneous labour compared to those who had induction of labour. No maternal or perinatal death was recorded. Trial of vaginal birth after one previous caesarean section is possible in low resource areas. The outcome would be improved with proper patient selection.