Ibrahim A Abdelazim1, Assem A M Elbiaa2, Mohamed Al-Kadi3, Amr H Yehia3, Bassam M Sami Nusair4, Mohannad Abu Faza5. 1. Department of Obstetrics and Gynecology, Ain Shams University Faculty of Medicine, Cairo, Egypt ; Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company (KOC), Ahmadi, Kuwait. 2. Department of Obstetrics and Gynecology, Ain Shams University Faculty of Medicine, Cairo, Egypt ; Department of Obstetrics and Gynecology, Sabah Maternity Hospital, Kuwait. 3. Department of Obstetrics and Gynecology, Ain Shams University Faculty of Medicine, Cairo, Egypt. 4. Department of Obstetrics and Gynecology and Reproductive Endocrinology, King Hussein Medical Center, Amman, Jordan. 5. Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company (KOC), Ahmadi, Kuwait.
Abstract
OBJECTIVE: To detect the maternal and obstetrical factors associated with successful trial of vaginal birth among women with a previous cesarean delivery. MATERIAL AND METHODS: A total of 122 women who were eligible for a trial of labor after cesarean section (TOLAC) according to departmental protocol were included in this comparative prospective study. After informed consent, the women included in this study were subjected to a thorough history to detect maternal and obstetric characteristics and a standard examination to estimate fetal weight, engagement of the fetal head, intra-partum features of fetal membranes, and cervical dilatation. After delivery, data on duration of labor, labor augmentation, mode of delivery, birth outcome, and neonatal intensive care (NICU) admission were recorded and analyzed. RESULTS: Trial of labor after cesarean section was successful in 72.13% and was unsuccessful in 27.87%. Body mass index (BMI) was significantly lower in the successful TOLAC group compared to the unsuccessful group (23.8±0.03 versus 26.2±0.02 kg/m(2)), and the number of women with BMI >25 kg/m(2) was significantly high in the unsuccessful group; also, mean gestational age was significantly lower in the successful TOLAC group compared to the unsuccessful group (37.5±0.04 versus 38.5±0.03 weeks), and the number of women admitted in labor with gestation ≥40 weeks was significantly high in the unsuccessful group. The number of women admitted with >2/5 of fetal head palpable abdominally and fetal head station ≥-2 was significantly high in the unsuccessful TOLAC group. CONCLUSION: In carefully selected cases, TOLAC is safe and often successful. Presence of BMI >25 kg/m(2), gestation ≥40 weeks, and vertex station ≥-2 were risk factors for unsuccessful TOLAC.
OBJECTIVE: To detect the maternal and obstetrical factors associated with successful trial of vaginal birth among women with a previous cesarean delivery. MATERIAL AND METHODS: A total of 122 women who were eligible for a trial of labor after cesarean section (TOLAC) according to departmental protocol were included in this comparative prospective study. After informed consent, the women included in this study were subjected to a thorough history to detect maternal and obstetric characteristics and a standard examination to estimate fetal weight, engagement of the fetal head, intra-partum features of fetal membranes, and cervical dilatation. After delivery, data on duration of labor, labor augmentation, mode of delivery, birth outcome, and neonatal intensive care (NICU) admission were recorded and analyzed. RESULTS: Trial of labor after cesarean section was successful in 72.13% and was unsuccessful in 27.87%. Body mass index (BMI) was significantly lower in the successful TOLAC group compared to the unsuccessful group (23.8±0.03 versus 26.2±0.02 kg/m(2)), and the number of women with BMI >25 kg/m(2) was significantly high in the unsuccessful group; also, mean gestational age was significantly lower in the successful TOLAC group compared to the unsuccessful group (37.5±0.04 versus 38.5±0.03 weeks), and the number of women admitted in labor with gestation ≥40 weeks was significantly high in the unsuccessful group. The number of women admitted with >2/5 of fetal head palpable abdominally and fetal head station ≥-2 was significantly high in the unsuccessful TOLAC group. CONCLUSION: In carefully selected cases, TOLAC is safe and often successful. Presence of BMI >25 kg/m(2), gestation ≥40 weeks, and vertex station ≥-2 were risk factors for unsuccessful TOLAC.
Authors: Jennifer A Tessmer-Tuck; Sherif A El-Nashar; Adrianne R Racek; Christine M Lohse; Abimbola O Famuyide; Myra J Wick Journal: Gynecol Obstet Invest Date: 2014-02-11 Impact factor: 2.031
Authors: Alison G Cahill; David M Stamilio; Anthony O Odibo; Jeffrey F Peipert; Sarah J Ratcliffe; Erika J Stevens; Mary D Sammel; George A Macones Journal: Am J Obstet Gynecol Date: 2006-07-17 Impact factor: 8.661
Authors: K Zh Sakiyeva; Ibrahim A Abdelazim; M Farghali; S S Zhumagulova; M B Dossimbetova; M S Sarsenbaev; G Zhurabekova; S Shikanova Journal: J Family Med Prim Care Date: 2018 Nov-Dec