Maternal outcomes in patients with previous one lower segment caesarean section undergoing trial of labour: prospective observational study

Authors

  • Veeramma . Department of Obstetrics and Gynecology, Ankura Hospital for Women and Children, Hyderabad, Telangana, India
  • Puneeta Mahajan Medical Superintendent, Dr. Baba Saheb Ambedkar Hospital, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181910

Keywords:

Bishops, Lower segment caesarean section (LSCS), Maternal age, Parity, Score, Trial of labour, Vaginal Birth after caesarean (VBAC)

Abstract

Background: The incidence of caesarean section is on the rise and has increased 2-3 folds from the initial rate of 10% during the last decade.  The objective of the present study was to compare maternal outcomes in successful and failed trial of labour in women with previous one LSCS.

Methods: This prospective observational study was carried out in Department of obstetrics & Gynaecology, Sanjay Gandhi memorial Hospital, New Delhi during 2015-2016 and included 150 gravid women with previous LSCS.   The study was undertaken during March 2015 to May 2016. The ethical committee approval for the study has been taken.

Results: out of 150 patients who had given a trial of labour, 64.7% (97) underwent successful VBAC and 35.3 %( 53) underwent emergency repeat LSCS. Majority of cases 59.3% were in age group <25 years followed by 36.7% in age group of 25-30 years. Most of the cases are para one 72.7% and remaining are multipara (27.3%). LSCS group: 83% para1 and 17% are multipara. VBAC group: 67.01 % para 1 and 32.9% multipara. There is no significant statistical difference between parity and mode of delivery. (p=0.591). Majority of cases 52.7% were in between 37-39 weeks and 47.3% cases were in between 39-42 weeks. Majority cases 89.3% had Bishop’s score 4-6 and 10.7% had Bishops score >6.

Conclusions: This study reveals that successful VBAC rate was 64.7% and 35.3% emergency repeat caesarean section.

References

Dutta DK. Caesarean delivery. Indications of caesarean section FOGSI India 1st ed, New Delhi, Jaypee brothers; 2005:7-12.

Cunningham FG, Levono KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Prior caesarean delivery. Williams Obstetrics. 24th ed, New York, McGraw Hill; 2014:609-619.

Akolekar R, Pandit SN, Rao SB. The caesarean Birth. Vaginal birth after caesarean delivery. FOGSI India, Mumbai, National book depot; 2010:148-56.

ACOG committee on Practice bulletins. Obstretrics. ACOG practice bulletin no. 115: Vaginal birth after previous Caesarean delivery. Washington (DC): Obstet Gynecol. 2010;116:450-63.

Shakti V, Behera RC, Sandhu GS, Anita S, Bandhu HC. Vaginal birth after caesarean delivery. J Obstet Gynecol India. 2006;56:320-3.

Mafatlal SJ, Narendrabhai MM. Analysis of mode of delivery in women with previous one cesarean section. J Obstet Gynecol India. 2009;59:136-9.

Islam A, Ehsan A, Arif S, Murtaza J, Hanif A. Evaluating trial of scar in patients with a history of caesarean section. N Am J Med Sci. 2011;3:201-5.

Chaudhari DR, Shindhe SM. Clinical profile and outcomes of labor in cases following previous cesarean section. Int J Health Sci Res. 2012;2:1-12.

Manohar R, Kavyashree G. Retrospective study of VBAC in a teaching hospital. Int J Recent Trends Sci Technol. 2013;8:244-7.

Singh N, Tripathi R, Mala YM. Maternal and fetal outcomes in patients with previous cesarean section undergoing trial of vaginal birth at a tertiary care centre in North India. J Preg Child Health. 2014;1:1-5.

Alsayegh AK, Roshdy S, Akef HA, Youssef MS. Induction of labor with Prostaglandin E2 in women with Previous Cesarean Section and Unfavourable cervix. Int J Health Sci Qassim University. 2007;1:211-5.

Qahatani NA, Borshid SA, Enezi HA. Induction of labor with PGE2 after one previous caesarean section:18 years’ experience in a University Hospital. Int J Clin Med. 2011;2:35-9.

Mishra N, Taori N, Misri A. Fetomaternal outcome of pregnancy with previous cesarean section. J Evolution Med Dent Sci. 2014;3:11369-78.

Singh RS, Kumar SR, Amin AS. Labor induction in patients with previous one caesarean section. Bombay Hospit J. 2015;57:138-42.

Downloads

Published

2018-04-28

Issue

Section

Original Research Articles