| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 11
| Issue : 1 | Page : 67-72 |
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Predictors of repeat cesarean section in women with one previous lower segment cesarean section: A retrospective study from Malaysia
Wan Mohd Hazman Wan-Nur-Hajidah1, Ab Hamid Siti-Azrin1, Bachok Norsa'adah1, Jummaat Fauziah2, Wan Adnan Wan-Nor-Asyikeen1
1 Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
2 Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Pulau Pinang, Malaysia
Correspondence Address:
Ab Hamid Siti-Azrin
Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan
Malaysia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjmms.sjmms_256_22
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Background: The rates of repeat cesarean section (CS) among women with previous CS are increasing worldwide. The predictors of a repeat CS can vary across different populations.
Objective: To determine the predictors of repeat CS among women from Malaysia with one previous lower segment CS (LSCS) who underwent trial of labor (TOLAC).
Materials and Methods: This retrospective cohort study included women with one previous LSCS who followed up and delivered their current pregnancy at Hospital Universiti Sains Malaysia (USM), Kelantan, Malaysia, between January 01, 2016, and December 31, 2017. Women with singleton pregnancies were included while those who had a history of classical CS, current pregnancy with preterm birth, non-cephalic pregnancy, lethal fetal anomalies, uterine rupture, and severe preeclampsia or planned for elective CS were excluded. Logistic regressions were performed.
Results: The study included 388 women who underwent TOLAC and successfully gave childbirth through vaginal birth after cesarean (VBAC) (n = 194) or emergency LSCS (n = 194). Factors significantly associated with repeat CS were no history of vaginal delivery (adjusted odds ratio (aOR): 2.71; 95% confidence interval (CI): 1.60, 4.60; P < 0.001), estimated fetal weight ≥3500 grams (aOR: 4.78; 95% CI: 2.45–9.34; P < 0.001), and presence of meconium-stained liquor (aOR: 2.40; 95% CI: 1.33–4.35; P = 0.004).
Conclusion: The above-mentioned predictors of a repeat CS among women from Malaysia with one previous LSCS who underwent TOLAC can be useful for clinicians in making an informed decision.
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