VAGINAL BIRTH AFTER CAESAREAN SECTION(VBAC) A TWO YEAR COMPARATIVE REVIEW OF OUTCOME AT ABUBAKAR TAFAWA BALEWA UNIVERSITY TEACHING HOSPITAL BAUCHI NIGERIA

Vaginal birth after caesarean section compared to a repeat caesarean has lower complication rate for both the parturient and her infant. Ruptured uterus is a major complication of Vbac and uterine rupture in a spontaneous labour after one prior lower transverse segment caesarean section is about 0.4%. The risk decreases by 50% after the first Vbac. The overall success rate of Vbac is between 52-80%, however in the West African sub region the success rate is almost 60%. A retrospective study was carried out between 1st January 2011 to 31st December 2012, on patients who were allowed Vbac within this period. Data was obtained from the delivery register, patients’ case files and theatre register. Maternal complications evaluated include ruptured uterus, postpartum haemorrhage and perineal tears. Fetal outcomes were evaluated based on the APGAR scores at birth. Data on Age, Parity and Booking status of women in the study were also obtained. Analysis was done using SPSS version 16.0 software package 2007. X2 test was used to test for significance and the results presented in form of tables. There were 12,775 deliveries during the study period and 204 women had Vbac giving a Vbac rate of 1.59%. The overall success rate of VBAC for the two years of the study was 45.1%. The success rate for Vbac in 2011 was 35.2% and for 2012 was 56.3% (X2=9.108, P=0.003). Vbac was more successful among booked patients (52.5%) compared to 34.5% in the unbooked patients (X2=6449, P=0.011). The rate of Vbac is low in our centre compared to reports elsewhere. Patients were better managed in 2012 leading to significantly improved success rate.