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

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 Ri o de Janeiro maternity hospital between 1992 and 1996. Sample: 141 cases (v aginal births after cesarean) and 304 controls (a new cesarean after other( s)). Multivariate analysis with logistic regression was carried out. Result s: The following characteristics were associated with greater probability o f 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 = 4.9 3-15.94); gestational age below 37 weeks (OR = 3.01; IC = 1.40-6.46); histo ry of at least one previous vaginal birth (OR = 2.12; IC = 1.18-3.82); leve l of education below high school (OR = 1.94; IC = 1.02-3.69). Chronic hyper tension reduced the chances of vaginal birth (OR = 0.44; IC = 0.22-0.88). C onclusions: Among the factors that can be modified to reduce the number of repeated cesareans are: trial of labor promotion, reducing admission of wom en at early stages of labor and adequate hypertension management during pre gnancy. Condensation: Among the factors that can be modified to reduce the number of repeated cesareans are: the trial of labor promotion for women wh o present previous cesarean, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy (C) 2001 Elsev ier Science Ireland Ltd. All rights reserved.