Korean J Perinatol.  2005 Sep;16(3):237-243.

The Impact of Previous Cervical Dilatation on the Duration of Vaginal Birth after Cesarean Delivery

Affiliations
  • 1Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea. spkim@catholic.ac.kr

Abstract


OBJECTIVE
This study examined the effect of a maximal cervical dilatation prior to their primary cesarean birth on the time length of labor in women attempting vaginal birth after cesarean section (VBAC).
METHODS
From January 2000 to Jun 2005, a total of 526 patients with VBAC were entered into the study. Patients were classified into 4 groups according to the maximal cervical dilatation on the prior cesarean birth: Group 1 (0~3 cm), Group 2 (4~7 cm), Group 3 (8~9 cm), and Group 4 (10 cm).
RESULTS
An analysis of the duration of labor showed that the time length of active phase was significantly shorter in each of Group 3 (147.3+/-103.9 minutes) and 4 (155.2+/-104.2 minutes) than in Group 1 (192.9+/-126.0 minutes) or 2 (195.1+/-148.2 minutes) (p<0.05), although there was no difference with regard to the second stage between each group. These results were also sustained even among the selected 248 patients without prior use of oxytocin, vacuum delivery, or epidural anesthesia that could affect the duration of labor.
CONCLUSION
The time length of active phase on VBAC is significantly shorter in women with a prior maximal cervical dilatation of > or =8 cm than those without. Study results indicate that prior cervical dilatation may affect the labor time of subsequent VBAC. The proper understanding of the association between prior cervical dilatation and labor time on a subsequent VBAC may be useful for better management or further intervention in the setting of VABC.

Keyword

VBAC; Duration of labor; Active phase; Second phase
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