Evaluation of Trials of Labour after Previous Caesarean Section in Ain Shams University Maternity Hospital: A Retrospective Study

Abstract

Trial of labour after previous caesarean delivery (TOLAC) provides women who desire a VD with the possibility of achieving that goal––a vaginal birth after caesarean delivery (VBAC). In addition to fulfilling a patient’s preference for VD, at an individual level VBAC is associated with decreased maternal morbidity and a decreased risk of complications in future pregnancies (risks of placenta accreta, increased chances of uterine rupture, and the morbidity related to multiple abdominal surgeries). At a population level, VBAC also is associated with a decrease in the overall CS rate. Proper candidates for planned TOLAC are those women in whom the balance of risks and chances of success are acceptable to the patient and health care provider, and this should be tailored individually. Although TOLAC is appropriate for many women with a history of a CS, several factors increase the likelihood of a failed TOL, which compared with VBAC, is associated with increased maternal and perinatal morbidity.