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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

MARTINEZ VILLAFANA, Enrique; ZETUNA BAGATELLA, Jorge Zarif  and  QUESNEL GARCIA BENITEZ, Carlos Alfredo. Factors associated with the success of a trial of labor after cesarean section (TOLAC) without a history of vaginal delivery. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.7, pp.493-498.  Epub Oct 31, 2023. ISSN 0300-9041.  https://doi.org/10.24245/gom.v91i7.8735.

OBJECTIVE:

To determine the factors associated with a trial of labor after a successful cesarean section in women with no history of previous delivery.

MATERIALS AND METHODS:

Observational case-control, longitudinal, retrospective, analytical, retrospective study performed in patient attended between 2017 and 2020 at Hospital Ángeles Lomas, with a singleton pregnancy of more than 37 weeks, with a trial of labor, with a previous cesarean section and no history of previous delivery. The independent variables were compared between the group that achieved a successful trial of labor after cesarean section with those of the group with failed trial. For statistical analysis, the IBM SPSS program, version 21, was used. All categorical variables are expressed in frequencies and percentages.

RESULTS:

We included 135 patients with trial of labor after cesarean section of whom 65 (48.1%) had labor (successful trial) and 70 (51.8%) had cesarean section (failed trial). There was a higher proportion of spontaneous labor in the successful trial group compared to the failed trial group (66.2% compared to 37.1%). There were no significant differences in labor conduction, amniotic membrane integrity on admission, hours of labor, and birth weight.

CONCLUSIONS:

Lower body mass index, spontaneous labor, and greater dilation on admission were significantly associated with a successful trial of labor after cesarean section. Membrane integrity, length of trial, and birth weight had no significant differences between groups.

Keywords : Trial labor; Cesarean section; Amniotic membrane; Body mass index; Dilatation.

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