Category: Labor
Poster Session IV
To examine the maternal characteristics and labor curve differences in patients that had an uncomplicated or patients that had a complicated vaginal birth after cesarean (VBAC).
Study Design:
This was a secondary analysis of patients at > 37 weeks’ gestation with a history of one prior cesarean section, no prior vaginal births that had a successful VBAC (N=1594) from the Consortium of Safe Labor (2002-2008). A complicated VBAC was defined as patients that had an estimated blood loss (EBL) of greater than 1000 mL, neonatal intensive care unit (NICU) admission, 5-minute APGAR score < 7, or 3rd or 4th degree laceration. Demographic variables were compared between patients that had an uncomplicated VBAC and patients that had a complicated VBAC using Chi-square test for categorical variables, and t-test or Wilcoxon rank sum test for continuous variables. Fifth-order polynomial regression model was performed to evaluate the labor curve in patients that had a successful VBAC.
Results:
A complicated VBAC occurred in 194 (12.2%) of patients. Patients that had an uncomplicated VBAC were more likely to be younger (27.5+/-5.5 vs 28.3+/-4.8, p=0.04) and smaller birthweight neonates (3337.3 +/- 415.4 vs 3446.2 +/- 451.9, p< .01) than patients that had a complicated VBAC. Patients that had an uncomplicated VBAC were less likely to have pre-gestational diabetes (13(0.09%) vs 8(4.1%), p< .01) than patients that had a complicated VBAC. There was no significant difference in the labor curves between patients that had an uncomplicated VBAC and patients that had a complicated VBAC (p=0.93).
Conclusion:
Older patients with pre-gestational diabetes are more likely to experience complications with a successful VBAC. However, the labor curve in patients that have a successful VBAC is not predictive of complications.
Rebecca L. Chornock, MD (she/her/hers)
MFM Fellow
MedStar Washington Hospital Center/Georgetown University Hospital
Arlington, Virginia, United States
Jim Huang, PhD
National Sun Yat-Sen University, Kaohsiung
Kaohsiung, Taiwan, Taiwan (Republic of China)
Tetsuya Kawakita, MD, MS, FACOG
Assistant professor
Eastern Virginia Medical School
Norfolk, Virginia, United States
Fatimah Z. Fahimuddin, MD
Maternal-Fetal Medicine Fellow
MedStar Washington Hospital Center
Arlington, Virginia, United States
Haleema Saeed, MD
Medstar Washington Hospital Center
Washington, District of Columbia, United States
Lylach Haizler-Cohen, MD (she/her/hers)
MFM/Genetics fellow
Medstar Washington Hospital Center
Washington, District of Columbia, United States
Diana Baxter, MD
MFM Fellow
MedStar Washington Hospital Center
Washington, District of Columbia, United States
Sara Iqbal, MD
Washington Hospital Center
Washington, District of Columbia, United States