Method cesarean was scarred uterus or previous cesarean

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Last updated: December 27, 2019

Method       Ten articles that met the selectioncriteria were reviewed. I searched  inCINAHL ,PubMed, science direct, Scopus and google schooler without languagerestrictions, from  to use  multiple subjects headings and free text keywords related to modes of birth  such as: vaginal birth after Cesarean, Cesarean section, VBAC ,repeat cesarean. Ourpopulation of interest included women who had one or more previous cesarean, women with history  VBAC and a repeat cesarean birth.

A review ofpublished research of the included following steps; comprehensive reading wasreviewed to identify areas of focus, identification of included and exclusioncriteria, literature search and retrieval, critical evaluation and analysis ofthe research evidence and synthesis of evidence was reviewed with the aims ofidentifying. Literature review      In Jordan, The study is apart of a comprehensive national study was conducted between 2011 and 2012 todetermine the rate and causes of cesarean birth showed that the increased rate of cesarean birth . This study concludedthat cesarean birth rate in Jordan is high(29.

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1%).The most common cause forplanned cesarean  was scarred uterus orprevious cesarean (59.4%) .cesarean birth is related to an increased risk ofneonatal death.

As most cesarean birth are currently based on doctor’s  judgment, it may be extremely helpful todevelop and implement a national guidelines for performing cesarean section .Obstetricians’ adherence should be monitored to comply with theseguidelines  .(Batieha et al.,2017)      The other study showed that the mostcommon  cause for cesarean  being “absence of a clear indication”(AlRifai,2014). In Jordan, like in many Arab countries, there is a preference fora large families. As cesarean birth limits the number of children, it becomes extremely important to performcesareans only when there are clear medical indications.

     Now the question becomes,previous cesarean section is a medical indication for repeat cesareansection?  if the answer is “no”, thenwhat is the level of care for subsequent births after cesarean birth? manystudies have been done to answer this question, assessing the benefits andrisks  of VBAC versus  repeat cesarean birth (ERCD) in order tobetter patient guidance and practice decision.   In a retrospective study,including uncomplicated women pregnancies and a history of one or more previous cesarean birth, whounderwent trial of  vaginal birth,supported by midwife or nurse  during theprenatal and intrapartum period.The  purpose of this study was to examinethe success rate and safety of vaginal birth after cesarean birth, as well asthe value of the contribution of midwives during the prenatal period andintrapartum period.  66 cases of trialvaginal birth after cesarean birth were examined between January /2013 andOctober /2014 in Greece. All were a high level of education, aged between 27-40 years old , under the care of the midwifes and the obstetricians during theprenatal and intrapartum period.

All pregnancies were uncomplicated withcephalic presentation. The most common indication previous cesarean, failedinduction of labor or the delay of labor progress (46%)( Nousia et al., 2014).During the  prenatal period, midwivesgave details information about the process of VBAC for women. In addition,midwives attempted to provide emotional support to pregnant women and teachthem position exercises and breathing techniques during labor, in order toprepare them for a successful vaginal birth after cesarean birth . During theintrapartum period  labor process ismonitored. Pain management was achieved by encouragement of the  ambulation, showers, emotional support andchanging positions of the mother.

The obstetricians were responsible for thedecision to labor augmentation, oxytocin administration or epidural anesthesia( Nousia et al., 2014). The study found that results: In total, 79% of thisstudy success rate of vaginal birth after cesarean birth , as 52 out of the 66women study group achieved vaginal birth. Labor spontaneously began in 89% of cases. All newborn had good Apgar scoresin the first minute and fifth minute after labor. No major complications, suchas uterine rupture or massive obstetric bleeding, were observed during thetrial of vaginal birth in any case. There was no need for blood transfusion,cesarean section or emergency hysterectomy in this  study ( Nousia et al.

, 2014).          This study the authors concluded that Itappears that pregnant women who have been informed and prepared from a midwife during the prenatal  period achieved higher rates of vaginal birthand satisfaction from the experience. All pregnant women should be informedabout the complications after repeated cesarean sections in comparison with thepotential risks of vaginal birth after cesarean birth and a trial of vaginalbirth should be offered if they agree with the process in the absence of otherobstetrical indicators  for cesareansection ( Nousia et al., 2014).      In a systematic review study by Rezai etal.

  (2016), vaginal birth aftercesarean  birth should be recommended forall women who have had  previous cesareanbirth, except : previous classical incision, previous hysterotomy or fullthickness myomectomy, previous uterine rupture, any contraindications to laborin this pregnancy (e.g. transverse lie ,placenta previa , etc.) (Rezai et al.,2016).

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