Vaginal Birth After Caesarean Section: Experience from a Secondary Healthcare Facility in Abuja, Northcentral Nigeria

VBAC Experience from a Secondary Healthcare Facility

Abstract

Vaginal Birth after Caesarean Section: Experience from a Secondary Healthcare Facility in Abuja, Northcentral Nigeria.

ABSTRACT

Background: There has been a disproportionate increase in caesarean section (CS) rate worldwide. Repeat elective CS for one previous CS contributes significantly to the high CS rate. Delivery options for a woman with one previous CS are trial of vaginal birth after caesarean section (VBAC) and elective repeat CS. VBAC is an important strategy to reduce the high rate of CS. When successful, VBAC obviates the need for a repeat CS on account of a previous CS and reduces the complications associated with it.

Aim: The aim of the study was to evaluate the practice and success rate of VBAC and its outcome in a secondary level healthcare facility.

Materials and Method: This was a retrospective analysis of women who attempted VBAC in a secondary level healthcare facility in Abuja, over a 5-year period between January 1^st 2018 to December 31^st 2022.

Results: The success rate of VBAC in this study was 36.4%. Failed VBAC rate resulting in emergency CS was 63.6% accounting for 3.3% of all CS within the study period. Multiparity, gestational age at delivery less than 40 weeks, and a history of a previous successful VBAC were significant factors for a successful VBAC. Overall, perinatal and maternal outcomes were good.

Conclusion:  VBAC success rate is low in our facility. Appropriate case selection and proper patient counselling are recommended to improve outcomes.

Key words: Vaginal birth after caesarean section, repeat elective caesarean section, foetal outcome, maternal complications.