DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150070

Study of comparison of maternal and fetal outcome of elective repeat caesarean versus vaginal birth in women after one prior lower segment caesarean section

Latika ., Gurcharan Kaur, Reetu Hooda, Sukhbir Singh

Abstract


Background: Caesarean section is almost one of the oldest operation in surgery with its origin lost in antiquity and ancient mythology. A heightened awareness must occur regarding the decision to perform the first caesarean section. Therefore, a study was planned to compare maternal and perinatal outcome between VBAC and repeat elective LSCS in prior one LSCS patients and their complications.

Methods: The study was undertaken in the department of Obstetrics and Gynecology at Kasturba hospital, Delhi. Total of one hundred (100) cases of previous one LSCS who were eligible for vaginal delivery were recruited and randomized in two groups (VBAC and repeat elective LSCS). Each group was having fifty (50) patients and prospective study was performed.

Results: It was observed that majority of the patients in group I (56%) and group II (40%) were in the age group of 20 to 24 years. Majority of the participants in both the groups were Muslims and majority of them were illiterate. Most of them were in the 39 to 40 weeks of gestation at the time of admission in the hospital. It was found that maximum number of neonates in Group I (80%) & Group II (76%) weighed between 2501-3000 grams. No maternal or perinatal death observed.

Conclusions: Vaginal Birth After Caesarean section (VBAC) has always remained a domain of controversies and dilemma in obstetrics. However with improved maternity care, close fetal monitoring and institutional delivery for a previous one caesarean section, VBAC is considered safer than repeat elective caesarean section in a carefully selected patient. 


Keywords


Caesarean section, VBAC, LSCS, Neonate

Full Text:

PDF

References


Phelan JP, Clark SL, Diaz F, Paul RH. Vaginal birth after caesarean. Am J Obstet Gynecol. 1987 Dec;157(6):1510-5.

Holland JG, Dupre AR, Blake PG, Martin RW, Martin JN Jr. Trial of labour after caesarean. J Obstet Gynecol. 1992;79:936.

Zelop CM, Shipp TD, Repke JT, Cohen A, Caughey AB, Lieberman E. Uterine rupture during induced or augmented labour in gravid women with one prior caesarean delivery. Am J Obstet Gynecol. 1999 Oct;181(4):882-6.

Ritchie JWK. Obstetric operations and procedure. In: Whitfield CR, eds. Dewhurst’s Textbook of Obstetrics and Gynecology for Postgraduates. 5th ed. Oxford: Blackwell Science; 1995: 392-396.

Cunningham Leveno, Bloom Hauth. Caesarean delivery and peripartum hysterectomy. In: Cunningham Leveno, Bloom Hauth, eds. Williams Obstetrics. 23rd ed. New York: McGraw-Hill Professional; 2010: 544.

Flamm BL, Goings JR, Liu Y, Wolde-Tsadik G. Elective repeat caesarean delivery versus trial of labour: a prospective multicenter study. Obstet Gynecol. 1994 Jun;83(6):927-32.

Whiteside DC, Mahan CS, Cook JC. Factors associated with successful vaginal delivery after caesarean section. J Reprod Med. 1983;28:785.

Flamm BL, Geiger AM. Vaginal birth after caesarean delivery: an admission scoring system. Obstet Gynecol. 1997;90:907-10.

Meier PR, Porreco RP. Trial of labor following cesarean section: a two-year experience. Am J Obstet Gynecol. 1982;144(6):671-8.

Paul RH, Phelan JP, Yeh SY. Trial of labor in the patient with a prior cesarean birth. Am J Obstet Gynecol. 1985;151(3):297-304.

Naef W 3rd, Ray MA, Chauhan SP, Roach H, Blake PG, Martin JN Jr. Trial of labor after caesarean delivery with a lower segment, vertical uterine incision: is it safe? Am J Obstet Gynecol. 1995;172:1666-74.

Rosen MG, Dickinson JC, Westhoff CL. Vaginal birth after caesarean: a meta-analysis of morbidity and mortality. Obstet Gynecol. 1991;77:465-70.

Pramod Kumar, Poonam Varma, Shivkumar, Arpita Jaiswal. Subjective assessment of LSCS scar site for vaginal birth after caesarean trial and outcome in MGIMS. Int J Biol Med Res. 2012;3(2):1825-9.

Ganitha G. Comparative study of immediate fetal outcome following trial of labour versus elective repeat caesarean section in a case of previous L.S.C.S with singleton pregnancy with vertex presentation. J Obstet Gynecol. 2005 Feb;10:2254.

Doshi Haresh, Jain Rohit, Vazirani Aarti. Prognostic factors for successful vaginal birth after caesarean section-analysis of 162 cases. J Obstet Gynecol India. 2010 Dec;60(6):498-502.

Muhammad Ali, Rashida Hafeez, Mansoor Ahmad. Maternal and fetal outcome: comparison between emergency caesarean section versus elective caesarean section. Prof Med J. 2005 Mar;12(1):32-9.

Trivedi SS, Puri M. Elective repeat caesarean section. In: Trivedi SS, Puri M, eds. Management of High Risk Pregnancy: A Practical Approach. 1st ed. New Delhi, India. Jaypee Brothers Medical Pub; 2010: 254-255.

Vardhan Shakti, Behera RC, Sandhu GS, Singh Anita, Bandhu HC. Vaginal birth after caesarean delivery. J Obstet Gynecol India. 2006 Jul/Aug;56(4):320-3.