Labor patterns in women undergoing vaginal birth after cesarean delivery

Hui-jing XU; Hong CUI

ABSTRACT

OBJECTIVE:

To describe labor patterns in women undergoing vaginal birth after cesarean(VBAC)and to ex⁃amine whether the labor pattern differed due to the different time of the previous cesarean.

METHODS:

In a retrospective observational study at Shengjing Hospital from January 2015 to July 2017,we compared the labor duration of latent、ac⁃tive phase and second stage among 50 women undergoing VBAC,51 nulliparous women and 51 multiparous women. Ac⁃cording to whether they had an elective cesarean(20)or a cesarean after a trial of labor(27)(data of 3 women was not available)in the previous pregnancy,the VBAC women were divided into two groups and compared the labor durations.

RESULTS:

There was no significant difference in median labor duration of latent phase among the groups(P>0.05). The median length of the active phase was 140,170 and 80 minutes in the VBAC,nulliparous and multiparous groups,re⁃spectively,and the VBAC was significantly longer than the multiparous(P<0.001).The median length of second stage for VBAC was 23 minutes which was significantly shorter than that of nulliparous(38 minutes,P<0.001)and longer than that of multiparous(9 min,P<0.001).Between subgroups within the VBAC according to whether they had an elective cesarean or a cesarean after a trial of labor in the previous pregnancy,there were no significant differences in the median labor duration of each stage.

CONCLUSION:

The labor patterns of first stage in women undergoing VBAC is similar to that of nulliparous,regardless of the indication for the previous cesarean,and labor curve shows a gradual smooth transition.The labor was faster for VBAC compared to nulliparous women in second stage.These findings on labor progress in VBAC should help obstetricians to manage labor,which improves the success rate of VBAC.