Vaginal birth after cesarean section versus elective repeat cesarean delivery: Weight-based outcomes

Objective: The study was undertaken to compare infectious morbidity and trial of labor (TOL) success stratified by weight in women. Study Design: Vaginal birth after cesarean section (VBAC) candidates were divided into groups based on prepregnancy weight: group I, 70 (<200 pounds); group II, 70 (200-300 pounds); and group III, 69 (>300 pounds). Results: The TOL success rate was 81.8% in group I compared with 57.1% in group II and 13.3% in group III (P = .001). The overall infectious morbidity was significantly greater in the obese women 39% (P =.001) compared with the average women at 11.4% and the lean women at 5.7%. Conclusion: Infectious morbidity is increased and VBAC success is reduced in patients who weigh more than 300 pounds. (Am J Obstet Gynecol 2003;188:1516-22.)