Title: Predictors and Risks of Vaginal Birth after Cesarean Section: Insights from a Regional Referral Hospital in Uganda
Author(s): Mirembe Ruth Getrude
Year 2024
File: PDF

Vaginal birth after cesarean section (VBAC) remains a topic of significant interest due to its potential benefits and
associated risks. This retrospective cohort study aimed to identify predictors and risks associated with VBAC
compared to elective repeat cesarean section (ERCD) among women delivering at Jinja Regional Referral Hospital
in Uganda. We analyzed data from 384 women who had a previous cesarean section and delivered at the hospital
between 2022 and 2023. Socio-demographic, obstetric, and medical characteristics were assessed for their
association with successful VBAC using logistic regression. Risks of maternal morbidities between VBAC and
ERCD groups were compared using Chi-square tests. The study found that BMI <35 kg/m², birth weight
<3500g, spontaneous onset of labor, previous safe vaginal birth, and absence of diabetes mellitus were significant
predictors of successful VBAC. Women undergoing TOLAC had a higher incidence of uterine rupture (p = 0.030),
thromboembolism (p < 0.001), and blood transfusion requirement (p < 0.001) compared to ERCD. However,
hysterectomy, hemorrhage, viscus injury, and pelvic floor trauma did not significantly differ between the two
groups. Our findings highlight important predictors and risks associated with VBAC compared to ERCD in a
regional referral hospital setting. Understanding these factors can aid clinicians in counseling women on their
delivery options and managing potential risks associated with VBAC. Further research is warranted to explore
strategies for optimizing VBAC outcomes while minimizing associated morbidities.
Keywords: Maternal, Morbidity, Labor, Cesarean Section, Elective Repeat Cesarean Delivery, Jinja, Hospital