Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia: a case control study

A case control study was conducted to compare the factors associated with successful VBAC in teaching hospitals in Addis Ababa in one year period. The cases were those successfully delivered vaginally and the controls were those with failed VBAC and delivered by caesarean section. The sample size of the cases was 101vaginal deliveries and the controls were 103 failed VBAC patients which made the case to control ratio of 1:1.In this study independent factors determining successful VBAC were, history of successful VBAC in the past, rupture of membrane at admission, and cervical dilatation of more than 3cm at admission. Presence of meconium, malposition and history of stillbirth were associated with failed VBAC. Factors like maternal age, past caesarean indications, inter delivery interval, and birth weight were not found to be significant determinants of success. The most common reason for repeat cesarean section for after trial of labor was labour dysfunction because of absence of a policy for augmentation on a scarred uterus in these hospitals.It is possible to prepare a decision tool on the success of VBAC by taking important past and present obstetric and reproductive performance history as predictor.Caesarean delivery is an operation done to deliver a baby through an incision in the uterus. It is the most frequently performed surgical procedure worldwide [1]. Even though, variation exists in rates of caesarean delivery across countries; currently the rate ranges from 10% to 40% [1,2]. This high caesarean section rate has put burden on the economy of nations and individuals.Previous caesarean section has been found to be the commonest cause of increased caesarean section rate in many parts of the world [1]. Because of increased risk of maternal complications with repeat caesarean section and safety of VBAC, trial of labour for selected group of patients with previous scar has become a preferred strategy [3].In1988 ACOG recommended that, in the absence of a contrai