gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Mode of delivery in women with prior cesarean section-the effect of non medical factors and obstetric history


Abstract

Author(s): ADAM CIEMINSK

Introduction. At present, in this group of women, the trial of vaginal labor takes into consi-deration among other things obstetric history. Between factors that exert an influence on modeof delivery more often are mentioned non medical factors.Aim. The aim of the study was to evaluate the non-medical factors, such as age, education,place of residence, and obstetrical history on the delivery method in the case of women aftera Caesarean section.Materials end methods. The study group consistit of 764 women with previous low transversecesarean section delivered in 1992-2002. The records were divided into 4 subgroups of pa-tients: 228 electively submitted to cesarean section, 44 delivered by emergency cesarean, 97delivered by cesarean after faild trial of labor and 395 delivered vaginaly. The aim of the studywas to assess the effect of maternal age, place of living, education and obstetric history on modeof delivery in women with prior cesarean section. The results were statystically analyzed.Results. The mean maternal age beetwen groups was similar ( 30 years ). The study found thatsuch parameters as maternal age, place of living, education are not associated with mode ofdelivery. The analysis of obstetric history revealed that patients with prior vaginal delivery inthe trial of labor group have higher rates of success (89,8%), compared with patients withouta history of prior vaginal delivery (53,4%). Among delivered after previous cesarean sectionin women with prior vaginal birth after cesarean delivery the success rate is higher (95,8%)compared with 83,3% in the group of patients with vaginal delivery prior to their cesareanbirth. Prior abortion and preterm delivery are not associated with the mode of delivery.Conclusions. Maternal age, place of living, education, prior abortion and prior preterm de-livery are not predictors for the mode of delivery in the women with prior cesarean section.The higher success rate of trial of labor is related to patients with prior vaginal delivery,particulary tho those with vaginal delivery after prior cesarean labor