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Vaginal Birth After Caesarean Section (VBAC): Possible Antenatal Predictors of Success and Role of Ultrasound

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Intrapartum Ultrasonography for Labor Management

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Abstract

Antenatal factors that may predict successful vaginal birth after caesarean (VBAC) play a relevant role to select patients who could be candidate to a trial of labour after caesarean section (TOLAC). There is a relevant antenatal scoring system and a nomogram for prediction of vaginal birth after caesarean delivery. A nonrecurring indication for previous caesarean section (CS) is associated with a much higher successful VBAC rate than recurrent indications. Prior vaginal deliveries can be considered excellent prognostic indicators of successful VBAC. A low vertical uterine incision does not seem to adversely affect VBAC success rates as compared to a low transverse incision. Maternal obesity and diabetes mellitus adversely affect VBAC outcomes. Foetal macrosomia does not appear to be a contraindication to VBAC, as success rates exceeding 50% are achieved and uterine rupture rates are not increased. Success rates decrease when interval increases. Twin gestation does not preclude VBAC. Post-date pregnancies may deliver successfully by VBAC in greater than two-thirds of cases. Mechanical induction should be preferred in case of post-date pregnancy. Attempted VBAC will be successful in the majority of attempted cases.

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Author information

Authors and Affiliations

  1. DMI-Department of Obstetrics and Gynaecology, ASM Matera, Matera, Italy

    Giuseppe Trojano & Nicola Antonio Carlucci

  2. Department of Obstetrics and Gynaecology, University Hospital Bari, Bari, Italy

    Claudiana Olivieri

  3. Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Riuniti Foggia, University of Foggia, Foggia, Italy

    Renata Beck

  4. Department of Obstetrics and Gynecology, Department of Biomedical and Human Oncological Science (DIMO), University of Bari, Bari, Italy

    Ettore Cicinelli

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  1. Giuseppe Trojano
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  2. Claudiana Olivieri
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  3. Nicola Antonio Carlucci
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  4. Renata Beck
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  5. Ettore Cicinelli
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Editors and Affiliations

  1. Department of Obstetric and Gynecology, Santa Maria Hospital, GVM Care and Research, Bari, Italy

    Antonio Malvasi

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Trojano, G., Olivieri, C., Carlucci, N.A., Beck, R., Cicinelli, E. (2021). Vaginal Birth After Caesarean Section (VBAC): Possible Antenatal Predictors of Success and Role of Ultrasound. In: Malvasi, A. (eds) Intrapartum Ultrasonography for Labor Management. Springer, Cham. https://doi.org/10.1007/978-3-030-57595-3_41

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  • DOI: https://doi.org/10.1007/978-3-030-57595-3_41

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