Patient Characteristics and Obstetric Outcomes of Successful Vaginal Birth after Cesarean Section: A Retrospective Study in a Tertiary Hospital in United Arab Emirates

Background: Vaginal birth after cesarean (VBAC) is a safe option for selected women, but success rates are influenced by maternal characteristics and obstetric history. This study aimed to evaluate the success of trial of labor after cesarean (TOLAC) and identify factors associated with successful VBAC among women with one previous cesarean scar. Materials and Methods: A retrospective observational study was conducted on 377 women with a single prior cesarean scar. Among them, 126 women were eligible for TOLAC. Data on maternal age, parity, previous vaginal delivery, prior TOLAC, and primary indications for cesarean were collected and analyzed. VBAC success rates were calculated, and associations between maternal factors and outcomes were assessed. Results: Overall, 22.2% of women eligible for TOLAC achieved successful VBAC. Women with a persisting indication for previous cesarean had a VBAC success rate of 16.0%, compared with 6.8% among those with a nonpersisting indication. Notably, women with a history of previous TOLAC had the highest success rate at 64.7%, while only 4.7% of women with a single cesarean scar achieved VBAC. Maternal age was significantly associated with success, with women aged ≥30 years having higher VBAC rates than those aged 20–29 years (9.5% vs. 2.6%, p = 0.018). Parity and previous vaginal delivery were strong predictors, with multiparous women achieving 31.9% success versus 3.9% among primiparous women, and 33.3% of women with prior vaginal births delivering successfully compared with 3.6% without. Conclusions: VBAC success is influenced by prior TOLAC, maternal age, parity, previous vaginal delivery, and cesarean indication. Individualized assessment of these factors is crucial for counseling women considering TOLAC and optimizing vaginal birth outcomes.