Predictors of successful vaginal delivery following cesarean section

Abstract

Objective: To determine predictors of successful vaginal delivery following primary
transverse segmental cesarean section for non-recurring cause. Design. Casecontrol
study. Institution: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela.
Methods: Pregnant women with spontaneous onset of labor and history of
cesarean section with transverse incision in the lower segment for non-recurrent
cause. The trial of labor was considered successful if it ended in vaginal delivery.
Main study measures: Maternal age, parity, frequency of labor prior to previous
cesarean section, gestational age at delivery, station of fetal cephalic presentation at
admission, and fetal weight. Results: A total of 126 pregnant women were selected,
of whom 85 (67.4%) had successful trials (vaginal delivery), while 41 (32.5%) had a
failed trial. No differences in general characteristics were found between groups (p
= ns). Univariate analysis showed that fetal weight equal to or less than 3,500 grams,
station of fixed or engaged fetal cephalic presentation, and gestational age less than
40 weeks were significant predictors of successful trial of labor outcome (p < 0.05).
Logistic regression analysis showed that fetal weight equal to or greater than 3,500
grams (p = 0.04) and station of floating - insinuated fetal cephalic presentation (p =
0.03) retained significance as predictors. Conclusion: Predictors for a successful trial
of vaginal delivery following cesarean section were fetal weight less than or equal to
3,500 grams and station of fixed or engaged fetal cephalic presentation.