Vaginal birth after cesarean section in Hawaii. Experience at Kapiolani Medical Center for Women and Children.

Medical records at Kapiolani Medical Center for Women and Children were reviewed for cases that had a trial of labor subsequent to prior cesarean section during the period January 1990 to July 1991. All cases were > or = delivered 36 weeks' gestation. During the 19-month period, 356/483 or 73.5% cases with a trial of labor had successful vaginal births after previous cesarean sections (VBAC). The majority of the others that did not were due to failure of progression in labor. The incidence of scar separation was 5/483 (1.04%). There were 5/483 neonates with Apgar scores of < or = 6 at 5 minutes, giving a perinatal morbidity rate of 1.04%. There were no maternal deaths. Oxytocin induction resulted in successful VBAC in 30/47 (63.8%) cases. This study concludes that a trial of labor for vaginal birth after cesarean section is well established at our institution. In addition, the rates of successful VBAC, its complications and outcomes, are comparable to national averages.