ArticleAnnals of Saudi medicine
Obstetric factors for unsuccessful trial of labor in second-order birth following previous cesarean.
Article in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Vaginal birth after cesarean section and its associated factors in Ethiopia: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2019Pooled it
- Investigating the Success Rate of Vaginal Delivery After Cesarean Section and Its Associated Factors in Afghan Women: Insights from a Maternity Hospital in Kabul.International journal of women's health · 2025Article
- Maternal and neonatal characteristics associated with clinical outcomes of TOLAC from 2012-20 in the USA: Evidence from a retrospective cohort study.EClinicalMedicine · 2022Article
- Factors Associated with Successful Vaginal Birth After a Primary Cesarean Section in Women with an Optimal Inter-Delivery Interval.International journal of women's health · 2021Article
- Clinical analyses of 66 cases of mid-trimester pregnancy termination in women with prior cesarean.Chinese medical journal · 2015Article
- Predictors of success of trial of labor after cesarean section: A nested case-control study at public hospitals in Eastern Ethiopia.Women's health (London, England)Article
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1 author at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe trial of labor after previous cesarean (TOLAC) is an important strategy to limit repeat cesarean sections and their complications. An unsuccessful TOLAC leads to maternal and neonatal morbidities. The success or failure of TOLAC after the first cesarean is determinant for the subsequent vaginal birth. Limited studies are available from low-income countries, exclusively conducted in women in their sec.ond-order birth following the first cesarean section. This study aims at determining the frequency of unsuccessful attempts at vaginal delivery in the second-order term (37-41+6/7 weeks) birth among women with previous cesarean sections and to describe maternal and obstetric factors for unsuccessful laborTOLACs in the same group. DESIGN AND SETTINGS: A cross-sectional study conducted from April to December 2010 at Obstetrics & Gynaecology Unit II, Civil Hospital Karachi. PATIENTS AND
methodsAll eligible patients at term pregnancy in their second-order birth were included. The frequency of unsuccessful attempts at vaginal birth was determined, followed by secondary analysis by calculating odds ratio for maternal and obstetric factors, that is, body mass index (BMI), hight, gestation ≥40 weeks, interdelivery interval, engagement of head in 5th, estimated fetal weight, ruptured membranes, duration of labor ≥7 hours, augmentation of labor, cervical dilatation < 4 cm, and vertex station -2 or higher on admission.
resultsOut of 122 study subjects, the proportion of unsuccessful vaginal birth after cesarean (VBAC) was 27.9% (n=34). Among maternal and obstetric factors, BMI > 25 (AOR, 5.00), gestation ≥40 weeks (AOR, 5.45), cervical dilatation < 4 cm (AOR, 5.90), and station of vertex -2 or higher (AOR, 3.83) had highly significant adjusted odds for failed TOLAC.
conclusionWith a well-defined protocol, the rates of unsuccessful attempts at VBAC are not high for the second-order birth. The risk of failure can be anticipated by factors such as BMI > 25, pregnancy duration ≥40 weeks, cervical dilatation < 4 cm, and vertex station -2 or higher on admission.
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