TITLE:
Maternal and Fetal Factors Associated with the Outcome of Trial of Labor after Cesarean in Four Reference Hospitals in Cameroon
AUTHORS:
Mboua Batoum Veronique Sophie, Djibrilou Hamadama, Christiane Nsahlaï Jivir Fomu, Ngo Dingom Madye, Nyada Serge Robert, Meka Ngo Um Esther Juliette, Mve Koh Valere
KEYWORDS:
Trial of Labor After Cesarean Outcome, Iterative Cesarean Section, Associated Factors, Hospital, Cameroon
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.13 No.4,
November
14,
2025
ABSTRACT: Introduction: Trial of Labor After Cesarean (TOLAC) is an alternative to iterative cesarean section. This study aimed to identify maternal-fetal factors associated with the outcome of TOLAC in four referral hospitals in Cameroon. Methodology: This was a retrospective case-control study conducted from January 2016 to December 2018 at the Yaoundé Central Hospital, the Yaoundé Teaching Hospital, the Douala Gyneco-Obstetric and Pediatric Hospital, and the Douala General Hospital. Cases (VBAC success) and controls (TOLAC failure) were matched according to maternal age and delivery site. Multivariate analysis identified factors independently associated with a favourable outcome. Results: Out of 468 women with unicatricial uterine who attempted vaginal delivery, 156 were successful and 312 were unsuccessful. Factors independently associated with a favorable outcome were: a favorable Bishop score (aOR = 42.24; 95% CI: 22.04 - 84.12), dilation ≥ 5 cm at admission (aOR = 7.63; 95% CI: 4.73 - 12.36), an estimated fetal weight between 2500 - 3500 g (aOR = 2.13; 95% CI: 1.44 - 3.17), clear amniotic fluid (aOR = 3.18; 95% CI: 1.73 - 6.16), and the absence of major obstetric comorbidities (aOR = 5.09; 95% CI: 2.1 - 14.73). Conclusion: Both maternal and fetal characteristics influence TOLAC outcomes. These results support the development of appropriate protocols to reduce unnecessary cesarean sections in resource-limited settings like Cameroonian hospitals.