THE SUCCESS RATE OF VAGINAL BIRTH AFTER CESAREAN SECTION USING VAGINAL BIRTH AFTER CESAREAN SECTION SCORE 

Taban Aziz Sidiq a and Sallama Kamel Nasir b



a Sulaimani Maternity Teaching Hospital, Kurdistan Region, Iraq.
b Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 
 

Submitted: 18/6/2019; Accepted: 17/2/2020; Published: 21/3/2020

ABSTRACT


Background 

Increasing cesarean section (C/S) rate had been led to the creation of many models for assessing the success of vaginal birth after cesarean section (VBAC) with the aim of reducing C/S. 


Objectives 

Assessment of VBAC success by VBAC score (Flamm Model); including each of its items, maternal body weight and fetal outcomes.


Patients and Methods

This is a cross-sectional study including 106 pregnant ladies who had history of previous C/S and admitted to Sulaimani Maternity Teaching Hospital, Sulaimani, Kurdistan/Iraq, during April the 1st, 2018 to April the 1st, 2019. Flamm Model [Maternal age, history of vaginal birth, reasons other than failure to progress for first C/S, cervical effacement, and cervical dilatation] scoring was used for assessment of VBAC success. The body mass index (BMI), mode of delivery, fetal and maternal outcomes were also recorded.


Results

There was significant association of Flamm Model scores with VBAC success rate {P-value “Pearson’s R Correlation (r)” = <0.001 (-0.742)}, i.e., the success rate was higher when the score was high. There were significant association of VBAC success rate with vaginal birth history, cervical effacement, cervical dilatation, fetal health, and BMI {P-value (r) = 0.047 (-0.101), <0.001 (-0.632), 0.001 (-0.329), <0.001 (0.39), and 0.001 (0.271)}, respectively. There were insignificant association between VBAC success rate with maternal age, reasons other than failure to progress for first C/S, and fetal weight {P-value (r) = 0.59 (0.053), 0.126 (0.148), and 0.21 (0.121)}.


Conclusion

Flamm Model is effective way of assessing VBAC and it can be used in our population.



KEYWORDS

Cesarean section, Flamm model, Vaginal birth after cesarean section (VBAC).