Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study
Abstract Background Trials of labor after cesarean section is the preferred strategy to decrease the cesarean delivery rate and reducing complications associated with multiple cesarean sections. The success rate of trials of labor after cesarean section and associated factors have not been well docu...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-06432-z |
| _version_ | 1797219558983991296 |
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| author | Gizachew Aynalem Tegegne Bayew Kelkay Rade Ayenew Engida Yismaw Worku Taye Berihun Agegn Mengistie |
| author_facet | Gizachew Aynalem Tegegne Bayew Kelkay Rade Ayenew Engida Yismaw Worku Taye Berihun Agegn Mengistie |
| author_sort | Gizachew Aynalem Tegegne |
| collection | DOAJ |
| description | Abstract Background Trials of labor after cesarean section is the preferred strategy to decrease the cesarean delivery rate and reducing complications associated with multiple cesarean sections. The success rate of trials of labor after cesarean section and associated factors have not been well documented in Ethiopia. Hence, this study was aimed to determine the success rate and factors associated with the trial of labor after one cesarean section in five Comprehensive Specialized Hospitals located in northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among 437 women who came for the trial of labor from December 1, 2021, to March 30, 2022. All women who fulfilled the eligibility criteria were included to this study. Data was collected using structured and pre-tested questionnaire. Then, the data was entered into Epi Data 4.6 software and exported to SPSS version 26 for analysis. To identify the variables influencing the outcome variable, bivariable and multivariable logistic regression analyses were conducted. The model’s fitness was checked using the Hosmer-Lemeshow goodness of fit test, and an adjusted odds ratio with a 95% confidence interval was used to declare the predictors that are significantly associated with TOLAC. Results The success rate of the trial of labor after one cesarean section was 56.3% (95% CI, 51.3%, 61.2%). Maternal age ≥ 35 years (AOR: 3.3, 95% CI 1.2, 9.3), the fetal station at admission ≤ zero (AOR: 5. 6, 95% CI 3.3, 9.5), vaginal delivery before cesarean section (AOR: 1.9, 95% CI 1.2, 3.2), and successful vaginal birth after cesarean delivery (AOR 2.2, 95% CI 1.2, 4.1) were found to have a significant association with the success rate of trial of labor after cesarean section. Conclusions In this study, the success rate of the trial of labor after a cesarean section was low as compared to the ACOG guideline and other studies in different countries. Therefore, the clinicians ought to offer counsel during antenatal and intrapartum period, encourage the women to make informed decision on the mode of delivery, and the practitioners need to follow fetal and maternal conditions strictly to minimize adverse birth outcomes. |
| first_indexed | 2024-04-24T12:35:34Z |
| format | Article |
| id | doaj.art-e0c28dfe2eb84fa0b2b825afc630de89 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-24T12:35:34Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-e0c28dfe2eb84fa0b2b825afc630de892024-04-07T11:33:48ZengBMCBMC Pregnancy and Childbirth1471-23932024-04-0124111010.1186/s12884-024-06432-zPredictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter studyGizachew Aynalem Tegegne0Bayew Kelkay Rade1Ayenew Engida Yismaw2Worku Taye3Berihun Agegn Mengistie4Department of Midwifery, Debremarkos Referral HospitalDepartment of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of GondarDepartment of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of GondarDepartment of Midwifery, Debremarkos Referral HospitalDepartment of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of GondarAbstract Background Trials of labor after cesarean section is the preferred strategy to decrease the cesarean delivery rate and reducing complications associated with multiple cesarean sections. The success rate of trials of labor after cesarean section and associated factors have not been well documented in Ethiopia. Hence, this study was aimed to determine the success rate and factors associated with the trial of labor after one cesarean section in five Comprehensive Specialized Hospitals located in northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among 437 women who came for the trial of labor from December 1, 2021, to March 30, 2022. All women who fulfilled the eligibility criteria were included to this study. Data was collected using structured and pre-tested questionnaire. Then, the data was entered into Epi Data 4.6 software and exported to SPSS version 26 for analysis. To identify the variables influencing the outcome variable, bivariable and multivariable logistic regression analyses were conducted. The model’s fitness was checked using the Hosmer-Lemeshow goodness of fit test, and an adjusted odds ratio with a 95% confidence interval was used to declare the predictors that are significantly associated with TOLAC. Results The success rate of the trial of labor after one cesarean section was 56.3% (95% CI, 51.3%, 61.2%). Maternal age ≥ 35 years (AOR: 3.3, 95% CI 1.2, 9.3), the fetal station at admission ≤ zero (AOR: 5. 6, 95% CI 3.3, 9.5), vaginal delivery before cesarean section (AOR: 1.9, 95% CI 1.2, 3.2), and successful vaginal birth after cesarean delivery (AOR 2.2, 95% CI 1.2, 4.1) were found to have a significant association with the success rate of trial of labor after cesarean section. Conclusions In this study, the success rate of the trial of labor after a cesarean section was low as compared to the ACOG guideline and other studies in different countries. Therefore, the clinicians ought to offer counsel during antenatal and intrapartum period, encourage the women to make informed decision on the mode of delivery, and the practitioners need to follow fetal and maternal conditions strictly to minimize adverse birth outcomes.https://doi.org/10.1186/s12884-024-06432-zEthiopiaPrior cesarean sectionTertiary hospitalsTrial of labor after cesarean sectionTOLAC |
| spellingShingle | Gizachew Aynalem Tegegne Bayew Kelkay Rade Ayenew Engida Yismaw Worku Taye Berihun Agegn Mengistie Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study BMC Pregnancy and Childbirth Ethiopia Prior cesarean section Tertiary hospitals Trial of labor after cesarean section TOLAC |
| title | Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study |
| title_full | Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study |
| title_fullStr | Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study |
| title_full_unstemmed | Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study |
| title_short | Predictors of successful trial of labor after cesarean section (TOLAC) in women with one prior transverse cesarean section at Tertiary Hospitals in northwest Ethiopia: a multicenter study |
| title_sort | predictors of successful trial of labor after cesarean section tolac in women with one prior transverse cesarean section at tertiary hospitals in northwest ethiopia a multicenter study |
| topic | Ethiopia Prior cesarean section Tertiary hospitals Trial of labor after cesarean section TOLAC |
| url | https://doi.org/10.1186/s12884-024-06432-z |
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