Objectives The consultation of women aspiring a vaginal birth after caesarean may be improved by integrating the individual evaluation of factors that predict their chance of success. Retrospective analysis of correlating factors for all trials of labor after caesarean that were conducted at the Department of Obstetrics of Charité-Universitätsmedizin Berlin, Campus Virchow Clinic from 2014 to October 2017. Methods Of 2,151 pregnant women with previous caesarean, 408 (19%) attempted a vaginal birth after cesarean. A total of 348 women could be included in the evaluation of factors, 60 pregnant women were excluded because they had obstetric factors (for example preterm birth, intrauterine fetal death) that required a different management. Results Spontaneous delivery occurred in 180 (51.7%) women and 64 (18.4%) had a vacuum extraction. 104 (29.9%) of the women had a repeated caesarean delivery. The three groups showed significant differences in body mass index, the number of prior vaginal deliveries and the child’s birth weight at cesarean section. The indication for the previous cesarean section also represents a significant influencing factor. Other factors such as maternal age, gestational age, sex, birth weight and the head circumference of the child at trial of labor after caesarean showed no significant influence. Conclusions The clear majority (70.1%) of trials of labor after caesarean resulted in vaginal delivery. High body mass index, no previous spontaneous delivery, and fetal distress as a cesarean indication correlated negatively with a successful vaginal birth after cesarean. These factors should be used for the consultation of pregnant women.

中文翻译：

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剖宫产后阴道分娩（VBAC）：害怕还是不敢？潜在风险因素的评估

目标 通过整合对预测其成功机会的因素的个体评估，可以改善对剖宫产后希望进行阴道分娩的妇女的咨询。对 2014 年至 2017 年 10 月在柏林 Charité-Universitätsmedizin 柏林校区 Virchow 诊所的产科进行的所有剖宫产后分娩试验的相关因素的回顾性分析。方法 2,151 名既往剖腹产的孕妇中，408 名 (19%) 尝试剖宫产后的阴道分娩。共有 348 名妇女可以被纳入因素评估，60 名孕妇被排除在外，因为她们有产科因素（例如早产、宫内胎儿死亡）需要不同的管理。结果 180 名 (51.7%) 妇女自然分娩，64 名 (18.4%) 妇女进行了真空引产。104 (29. 9%）的妇女多次剖腹产。三组在体重指数、既往阴道分娩次数和剖宫产时孩子的出生体重方面表现出显着差异。之前剖宫产的指征也是一个重要的影响因素。其他因素如产妇年龄、胎龄、性别、出生体重和剖宫产试产时孩子的头围均无显着影响。结论 绝大多数 (70.1%) 剖宫产后分娩试验导致阴道分娩。高体重指数、既往无自然分娩和剖宫产指征的胎儿窘迫与剖宫产后顺产成功呈负相关。这些因素应该用于咨询孕妇。