VBAC In Women Undergoing IOL With Dinoprostone Versus Spontaneous Labor

João Alves, Cristina Vilhena, Cláudia Tomás, Isabel Lobo Antunes, José Metello, Isabel Natário, Marco Puga, Ester Casal

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OBJECTIVE: To compare the rate of vaginal birth in women attempting vaginal birth after caesarean delivery (VBAC) through
labour induction with dinoprostone versus a trial of spontaneous labour.
METHODS: A 10-year retrospective cohort study in a tertiary care hospital of women with one prior caesarean delivery. Women
who attempted VBAC with labour induction with dinoprostone were compared with women undergoing spontaneous labour.
Logistic regression analyses were performed to assess the relationship between VBAC success and labour induction taking into
account confounding variables. Both maternal and neonatal safety were studied to find a difference between the group with
spontaneous labour versus the group labour induction.
RESULTS: A total of 1076 women in the cohort attempted VBAC (649 with spontaneous labour and 427 with induced labour).
Women who were given a trial of spontaneous labour were more likely to have a successful VBAC (70.3% compared with
48.7%, odds ratio (OR) 2.49, 95% confidence interval (CI) 1.93–3.21). If women have had a previous vaginal delivery they were
more likely to have a successful VBAC, OR of 2.98, 95% CI 2.08-4.27. The risk of uterine rupture (0.5% for induced labour
compared with 0.6% for spontaneous labour) or overall morbidity (2.7% compared with 2.1%) was not significantly increased in
the women with labour induction.
CONCLUSION: Women with a previous caesarean section have a lower VBAC rate with labour induction versus spontaneous
labour. If they have a previous vaginal delivery, the chance of a vaginal delivery increases. Overall, vaginal birth is safe and
effective in women with one caesarean section with labour induction with dinoprostone.
Original languageEnglish
Pages (from-to)1-6
JournalThe Internet Journal of Gynecology and Obstetrics
Issue number1
Publication statusPublished - 2015


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