Vaginal birth after caesarean section in a population with a low overall caesarean section rate

Bais, Joke M.J.; van der Borden, Diana M.R.; Pel, Maria; Bonsel, Gouke J.; Eskes, Martine; van der Slikke, Hans J.W.; Bleker, Otto P.

« Previous Next »European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 96, Issue 2 , Pages 158-162, June 2001

Vaginal birth after caesarean section in a population with a low overall caesarean section rate

Joke M.J. Bais
- Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
Diana M.R. van der Borden
- Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
Maria Pel
- Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
- Corresponding author. Fax: +20-6963-489
Gouke J. Bonsel
- Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
Martine Eskes
- Department of Obstetrics and Gynecology, de Heel Hospital, Zaandam, The Netherlands
Hans J.W. van der Slikke
- Department of Obstetrics and Gynecology, de Heel Hospital, Zaandam, The Netherlands
Otto P. Bleker
- Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands

Received 12 February 2000; received in revised form 16 April 2000; accepted 12 May 2000.

Abstract

Objective: To determine the clinical outcome of vaginal birth after caesarean section (VBAC) in a Dutch population with a low overall caesarean section (CS) rate of 6.5%. Study Design: Prospective population based cohort study of 252 patients with a previous caesarean section (CS). Outcome parameters were trial of labour (TOL), success rate and VBAC rate. Results: The TOL rate in the study cohort was 73%, success rate 77%, VBAC rate 56%. The reason for the previous CS influenced success rate. Complications, morbidity and mortality were not different between elective, emergency CS and TOL group, except for a higher incidence of haemorrhage more than 500ml in the elective CS compared to the TOL group (29% versus 17%, relative risk (RR) 1.74 (1.15–2.34)). Conclusions: In this Dutch study the success rate is comparable to rate in US study reports. Increase of the VBAC rate can mainly be achieved by increasing the number of women attempting TOL.