Document Type : Original Article
Authors
1
Assistant Professor, Family and the youth of population Support Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2
Associate Professor of IVF and infertility, Supporting the family and the youth of population Research Core, Department of obstetrics and gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
3
Associate Professor of Maternal-Fetal Medicine, Supporting the family and the youth of population Research Core, Department of obstetrics and gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
4
Specialist assistant, Department of obstetrics and gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
5
Associate Professor of Female pelvic disorder and reconstructive surgery, Supporting the family and the youth of population Research Core, Department of obstetrics and gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, I
6
Specialist, Department of obstetrics and gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
10.22038/ijogi.2025.87454.6420
Abstract
Introduction: Based on the potential benefits of vaginal delivery (VD) for mothers and infants, and the attention of regulatory organizations to reduce the number of unnecessary cesareans, this study aimed to examine maternal and fetal complications of VD in individuals with a history of two previous cesareans (VBAC) and compare them with the repeat cesarean group.
Methods: This was a prospective cohort study conducted from 2019 to 2021 on 100 pregnant women with a history of two previous cesareans visiting Imam Reza & Omolbanin Hospitals. Participants were randomly divided into two equal groups: candidates for VBAC or cesarean delivery. Maternal and neonatal outcomes in both groups were analyzed using SPSS version 24. p-value of less than 0.05 was considered significant.
Findings: The average age in the VBAC group was 27.35 years and in the repeat cesarean (RCD) group was 34.47 years, showing a significant difference (P=0.001). The average number of pregnancies in the VBAC group did not differ from that in the RCD group. The underlying diseases (diabetes, preeclampsia, and chronic hypertension) were more common in the RCD group (P=0.000). Blood transfusion and postpartum hemorrhage were more frequent in the RCD group (P=0.009). Admission to the NICU was higher in the RCD group (13%) (P=0.001). Satisfaction with VBAC was 97% and significantly higher (P=0.00).
Conclusion: Given the increased complications after repeat cesarean, including postpartum hemorrhage rates, the need for blood transfusions, and lower maternal satisfaction with RCD delivery, VBAC should be presented as a safe method for qualified mothers.
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