DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183327

Outcome of pregnancy in women with previous one cesarean section

Manish Mittal, Meenakshi Kandoria, Rajeev Sood, Monica Chauhan, Rohini Rao, Shaina .

Abstract


Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).

Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.

Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.

Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL.


Keywords


Elective repeat cesarean section, Trial of scar, Trial of labour, VBAC

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References


Mafatlal SJ, Narendrabhai MM. Analysis of mode of delivery in women with one cesarean section. JObstet Gynecol India. 2009;59(2):136-39.

Gupta P, Jahan I, Jograjiya GR. Is vaginal delivery safe after previous lower segment caesarean section in developing country? Niger Med J. 2014;55:260-5.

King TL. First do no harm: the case for vaginal birth after cesarean. J Am college of Nurse-midwives. 2010;55(3):202-5.

Wazzan-Al. RM. Factors affecting success of trial of labour after previous one lower segment Caesarean section. J Ann. Coll. Med. Mosul. 2010;36(1&2):121-9.

Gonen R, Barak S, Tamir A, Ohel G. Results of a well-defined protocol for a trial of labor after prior caesarean section.J Obstet Gynecol. 2006;107:240-5.

Madaan M, Agrawal S, Nigam A, Aggarwal R, Trivedi SS.Trial of labour after previous caesarean section: the predictive factors affecting outcome. J Obstet Gynecol. 2011;31(3): 224-8.

Eskander M, Jameelah A, Majed A, Mervat H, Azza. Optimization of clinical outcome of women with previous one lower segment cesarean section. J Obstet Gynecol. 2012;2:265-9.

. Bujold E, Blackwell CS, Hendler I, Berman S, Sorokin Y, Gauthier JR. Modified Bishop’s score and induction of labor in patients with a previous cesarean delivery.Am J Obstet and Gynecol 2004; 19:1644-48.

Weinstein D, Benshushan A, Ezra Y, Rojansky N. Vaginal birth after cesarean section. Int J Gynaecol Obstet. 1996; 53:1-10.

Chaudhari DR, Shinde SM. Clinical profile and outcome of labour in cases following previous caesarean section. Int J Observational study. Int J of Women’s Health. 2012:6 301-5.

Puri P, Abraham M, Grover S. Vaginal birth after one previous lower segment caesarean section. J K Sci. 2011; 13(4).180-1.

Balachandran L, Vaswani RP and Mogotlane R. Pregnancy outcome in women with previous one cesarean section. J Clin Diag Res. 2014;8(2):99-102.

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

Rahman R, Khanam NN, Islam N, Begum KF, Pervin HH, Arifuzzaman M. The outcome of vaginal birth after caesarean section (VBAC): a descriptive study. Medicine Today. 2013;25(1):14-7.

Taj A, Naqvi SB, Yasmeen T. Vaginal birth after caesarean section at Liaquat National Hospital. Pak J Surg. 2012;28(1):81-4.

Blanchette H, Blanchette M, McCabe J, Vincent S. Is vaginal birth after cesarean safe? Experience at a community hospital. Am J Obstet Gynecol. 2001;184:1478-84; discussion 1484-87.

Landon MB, Leindecker S, Spong C, Hauth JC, Bloom S, Varner MW et al. The MFMU Cesarean Registry: Factors affecting the success of trial of labor after previous cesarean delivery. Am J Obstet Gynecol. 2005;193(3):1016-23.

Agarwal A, Chowdhary P, Das V, Srivastava A, Pandey A, Sahu MT. Evaluation of pregnant women with scarred uterus in a low resource setting. J Obstet Gynaecol Res. 2007;33(5):651-4.

Hibbard. JU, Muhammed IA, Yantao W, Catherine T, Karrison T. Failed vaginal birth after a cesarean section: How risky is it?. Am J Obstet Gynecol. 2001;184:1365-73.

Bangal VB, Giri PA, Shinde KK, Gavhane SP. Vaginal birth after cesarean section. North Am J Med Sci. 2013; 5:140-44.