Vaginal birth after caesarean section

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Abstract

Background: • The proportion of women who decline vaginal birth after caesarean section is a significant determinant of overall rates of caesarean birth, hence the need for this audit. Objective: • To assess compliance with Departmental Guideline on Vaginal Delivery following Caesarean Section • To determine Vaginal Birth Rate after single previous Caesarean Section (CS). • To encourage medical staff to use the guideline when managing patients with previous CS. Patients and Methods: • A retrospective review in Antrim Area Hospital, the largest Maternity Unit in the Northern Trust, Northern Ireland. • 96 women with one previous caesarean section with or without history of vaginal delivery were included in the audit. Results: • 66% of women were planned for elective repeat caesarean section (ERCS), while 34% opted to try for vaginal birth after caesarean section (VBAC). Of the 34%, 13% had VBAC while 21% had emergency caesarean section. Overall, the successful VBAC rate was 37%. Conclusions and discussion: • Compared to quoted figures of VBAC rate of 72-76%, we achieved a significantly lower rate of 37%. Could this be because: • of poor selection • we have a better informed obstetric population who are more involved in decision making? • those who plan for fewer children are less frightened of the safety of CS. • patients are scared off as a result of the obligatory discussion of scar dehiscence and potential risks to baby? Caesarean Section in these patients contributes significantly to our overall CS rate.

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APA

Wilkinson, C., Mcllwaine, G., Patel, N., Hickey, K., & Hickey, W. (1995, March 18). Vaginal birth after caesarean section. The Lancet. https://doi.org/10.1016/S0140-6736(95)90897-8

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