Factors associated with vaginal birth after cesarean in a maternity hospital of Rio de Janeiro.

ABSTRACT

OBJECTIVES: Identifying characteristics associated with vaginal birth after cesarean. STUDY DESIGN: Case-control study based on medical records. STUDY POPULATION women with previous cesarean, who had delivered in a public Rio de Janeiro maternity hospital between 1992 and 1996. SAMPLE 141 cases (vaginal births after cesarean) and 304 controls (a new cesarean after other(s)). Multivariate analysis with logistic regression was carried out. RESULTS: The following characteristics were associated with greater probability of vaginal birth (IC=95%) only one previous cesarean (OR=19.05; IC=6.88-52.76); cervical dilatation at admission above 3 cm (OR=8.86; IC=4.93-15.94); gestational age below 37 weeks (OR=3.01; IC=1.40-6.46); history of at least one previous vaginal birth (OR=2.12; IC=1.18-3.82); level of education below high school (OR=1.94; IC=1.02-3.69). Chronic hypertension reduced the chances of vaginal birth (OR=0.44; IC=0.22-0.88). CONCLUSIONS: Among the factors that can be modified to reduce the number of repeated cesareans are trial of labor promotion, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy. CONDENSATION Among the factors that can be modified to reduce the number of repeated cesareans are the trial of labor promotion for women who present previous cesarean, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy.