Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia a case control study.docVIP

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Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia a case control study.doc

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Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia a case control study

BiraraandGebrehiwotBMCPregnancyandChildbirth2013,13:31 /1471-2393/13/31 RESEARCH ARTICLE OpenAccess Factorsassociatedwithsuccessofvaginalbirth afteronecaesareansection(VBAC)atthree teachinghospitalsinAddisAbaba,Ethiopia:a casecontrolstudy MaledeBirara*andYirguGebrehiwot Abstract Background:Vaginaldeliveryafterpreviousonecesareansectionforanonrecurringindicationhasbeen describedbyseveralauthorsassafeandhavingasuccessrateof60–80%.HencemanycentersareofferingVBAC forcandidatesleavingthecenturyolddictumofoncecesareanalwayscesarean.ButpredictingsuccessofVBAC aftertrialoflabor(TOL)isstilladifficulttaskduetothelackofavalidatedpredictiontool.Studiesonpredictorsof successarefewandmostofthemconductedindevelopedcountriesanddifficulttogeneralize.Therefore assessingfactorsassociatedwithsuccessfulVBACisveryimportanttoforcounselingmotherswhileofferingVBAC. TheaimofthisstudywastoassessfactorsassociatedwithsuccessfulVBACinthreeteachingHospitalsinAddis AbabaEthiopia. Methods:AcasecontrolstudywasconductedtocomparethefactorsassociatedwithsuccessfulVBACinteaching hospitalsinAddisAbabainoneyearperiod.Thecaseswerethosesuccessfullydeliveredvaginallyandthecontrols werethosewithfailedVBACanddeliveredbycaesareansection.Thesamplesizeofthecaseswas101vaginal deliveriesandthecontrolswere103failedVBACpatientswhichmadethecasetocontrolratioof1:1. Result:InthisstudyindependentfactorsdeterminingsuccessfulVBACwere,historyofsuccessfulVBACinthepast, ruptureofmembraneatadmission,andcervicaldilatationofmorethan3cmatadmission.Presenceofmeconium, malpositionandhistoryofstillbirthwereassociatedwithfailedVBAC.Factorslikematernalage,pastcaesarean indications,interdeliveryinterval,andbirthweightwerenotfoundtobesignificantdeterminantsofsuccess.The mostcommonreasonforrepeatcesareansectionforaftertrialoflaborwaslabourdysfunctionbecauseofabsence ofapolicyforaugmentationonascarreduterusinthesehospitals. Conclusion:ItispossibletoprepareadecisiontoolonthesuccessofVBACbytakingimportantpastandpresent obstetricandreprod