Feto-Maternal Outcome of Vaginal Birth after Cesarean and Associated Factors Among Mothers with Previous Cesarean Scar at Attat Lord Merry Primary Hospital, Gurage Zone, South Ethiopia

Abstract

Background: Vaginal delivery after previous one cesarean section for a non-recurring indication has been described by several authors as safe and having a success rate of 60-80%. Hence, many health professionals were encouraging Vaginal Birth After Cesarean (VBAC) for candidates leaving the century old dictum of once cesarean always cesarean. However, predicting success of VBAC following Trial of Scar (TOS) is still a difficult task due to the lack of a validated prediction tool. In addition to this, feto-maternal outcome was also uncertain and unknown in the study area including factors associated with. Hence, the objective of this study was to determine the perinatal and maternal outcome of pregnancy and factors associated with success of VBAC among mothers who had previous one cesarean section and gave birth at Attat Catholic Primary Hospital, South Ethiopia. Methods: Facility based retrospective cross-sectional study design was used at Attat Catholic Hospital, Ethiopia from October 01/2015-Septmeber 30/2016. The data was collected from October 01-15, 2016. The data on Sociodemographic, obstetric factors and outcome related variables were collected from medical record books using pretested data collection tool by trained data collectors. The collected data were coded, cleaned and entered to SPSS version 21 for analysis. Descriptive statistics was used to describe some of study variables. Logistic regression analysis (bivariate and multivariable logistic regression) was employed. Statistical tests such as Odds ratio (absolute measure of association) with 95% CI was used to see the associations. A P<0.05 was considered as statistically significant in all types of tests to declare significance. Results : Out of all mothers who gave birth, 169 mothers gave birth with pervious one caesarean section scar from which repeated caesarean section was 104 (61.5%). Majority 81 (78%) of them were done as an emergence and 146 offered TOS. Less than half of them 65 (44.5%) had successful VBAC and Cephalo-Pelvic Disproportion (CPD) was the major indication for failed VBAC. Passage of liquor at admission (AOR: 0.25, 95% CI: 0.084,0.733), history of vaginal birth after cesarean (AOR: 1.88, 95% CI : 0.084, 0.733), cervical dilation at admission (AOR: 8.171, 95% CI: 3.303, 34.473) and type of indication for pervious cesarean section (AOR: 0.703, 95% CI: 0.014, 0.364) were significant factors associated with success of VBAC. Conclusion: Successful vaginal delivery after one previous cesarean scar was 45.5% which was relatively low. Trial of vaginal birth after cesarean section should be encouraged for appropriate cases. Before indicating mothers for cesarean delivery due to only having history of previous one cesarean section, attention should be given to the indication to avoid unnecessary cesarean section. *Corresponding author: Yibeltal Siraneh, Department of Health Economics, Management and Policy, Faculty of Public Health, Institute of Health, Jimma University, Ethiopia, Tel: +251917017092; Fax: +6622437907; E-mail: yibeltal_siraneh@yahoo.com Received: September 05, 2018; Accepted: September 19, 2018; Published: September 26, 2018 Citation: Siraneh Y, Assefa F, Tesfaye M (2018) Feto-Maternal Outcome of Vaginal Birth after Cesarean and Associated Factors Among Mothers with Previous Cesarean Scar at Attat Lord Merry Primary Hospital, Gurage Zone, South Ethiopia. J Preg Child Health 5: 390. doi:10.4172/2376-127X.1000390 Copyright: © 2018 Siraneh Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.