Maternal and Fetal Outcomes of Vaginal Delivery or Repeat Cesarean in Mothers with Two Previous Cesarean Sections

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Supporting the Family and the Youth of Population Research Core, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

2 Gynecologist, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

3 Gynecologist, Department of Obstetrics and Gynecology, Supporting the Family and the Youth of Population Research Core, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

4 PhD Student in Biostatistics, Department of Epidemiology and Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Assistant Professor, Department of Obstetrics and Gynecology, Supporting the Family and the Youth of Population Research Core, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

10.22038/ijogi.2025.87454.6420

Abstract

Introduction: Considering to 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 was conducted with aim 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 semi-experimental study was conducted in 2019 to 2021 on 100 pregnant women with a history of two previous cesareans visiting Imam Reza & Omolbanin Hospitals. Participants were referred to two groups: candidates for VBAC or cesarean delivery. Maternal and neonatal outcomes were compared in both groups. Data were analyzed using SPSS (version 24) and independent t, Chi-square, and Fisher tests. P<0.05 was considered significant.
Results: The mean number of pregnancies did not differ in the two groups (P>0.1). In the RCD group, the underlying diseases (diabetes, preeclampsia, and chronic hypertension) (P<0.001), blood transfusion and postpartum hemorrhage (P=0.009), admission to the NICU (12%) (P=0.001) were higher than the VBAC group. Satisfaction with delivery was significantly higher in VBAC group (96%) (P<0.001).
Conclusion: Given the increased complications after repeat cesarean, including postpartum hemorrhage rates, the need for blood transfusions, and lower maternal satisfaction with RCD, VBAC should be presented as a safe method for qualified mothers.

Keywords

Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 8
October 2025
Pages 1-9

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