DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222791
Published: 2022-10-28

Maternal and fetal outcomes following the trial of vaginal delivery and elective repeat caesarean section in term pregnancy with one previous lower segment caesarean section in Dr. Baba Saheb Ambedkar Hospital: a prospective controlled study

Puneeta Mahajan, Vinita Gupta, Neha Agrawal

Abstract


Background: Before 1970s, the phrase “once a caesarean, always a caesarean” was a common norm. Now this phrase has been changed to “once a caesarean, always an institutional delivery”.

Methods: This prospective controlled study was carried out in department of obstetrics and gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi for a period of 7 months (October 19 to April 2020) and included 200 gravid women with previous one lower segment caesarean section (LSCS). The ethical committee approval for the study was taken.

Results: The success rate of trial of labour after caesarean (TOLAC) in our study was 67%. It was concluded from this study that the percentage of woman having complications were maximum in failed TOLAC patients which was 69.70% followed by patients undergoing elective repeat caesarean delivery (ERCD) which was 59% followed by women having successful VBAC which was 8.96%. The percentage of neonate having complications were maximum in neonate of failed TOLAC patients which was 27.27% followed by neonate of patients undergoing ERCD which was 21% followed by neonate of women having successful VBAC which was 5.97%.

Conclusions: TOLAC for a second delivery is a much-needed feasible option in developing countries to reduce the cost and morbidities of repeat caesarean deliveries.


Keywords


Elective repeat caesarean delivery, Elective repeat caesarean section, Lower segment caesarean section, Trial of labour, Trial of labour after caesarean, Vaginal birth after caesarean

Full Text:

PDF

References


Peleg D, Burke YZ, Solt I, Fisher M. The history of the low transverse cesarean section: the pivotal role of Munro Kerr. Isr Med Assoc J. 2018;20(5):316-9.

Douglas RG, Birnbaum SJ, MacDonald FA. Pregnancy and labour following caesarean section. Am J Obstet Gynecol. 1963;8(6):961-71.

Flamm BL, Newman LA, Thomas SJ, Fallon DE, Yoshida MM. Vaginal birth after cesarean delivery: results of a 5-year multicenter collaborative study. Obstetrics and Gynecology. 1990;76(5 Pt 1):750-4.

Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ. 2004;329(7456):19.

World Health Organization. WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization, 2018. Available from: https://apps.who.int/iris/bitstream/ handle/10665/260178/9789241550215-eng.pdf. Accessed on 10 July 2022

American College of Obstetricians and Gynecologists. Vaginal birth after previous caesarean delivery. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 1999; 66:197-204.

George A, Arasi KV, Mathai M. Is vaginal birth after caesarean delivery a safe option in India? Int J Gynaecol Obstet. 2004;85:42-3.

Sen S, Malik S, Salhan S. Ultrasonographic evaluation of lower uterine segment thickness in patients of previous cesarean section. Int J Gynecol Obstet. 2004;87(3):215-9.

Mozurkewich EL, Hutton EK. Elective repeat caesarean delivery versus trial of labour: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol. 2000;183:1187-97.

Troyer LR, Parisi VM. Obstetric parameters affecting success in a trial of labour: designation of a scoring system. Am J Obstet Gynecol. 1992;167:1099-104.

Thurnau GR, Scates DH, Morgan MA. The fetal-pelvic index: a method of identifying fetal-pelvic disproportion in women attempting vaginal birth after previous Caesarean delivery. Am J Obstet Gynecol. 1991;165:353-8.

Tsai HT, Wu CH. Vaginal birth after caesarean section-The world trend and local experience in Taiwan. Taiwan J Obstet Gynecol. 2017;56(1):41-5.

Yang YZ, Ye XP, Sun XX. Maternal and neonatal morbidity: repeat caesarean versus a trial of labour after previous caesarean delivery. Clin Invest Med. 2017;40(3):135-45.

Cahill AG, Stamilio DM, Odibo AO, Peipert JF, Ratcliffe SJ, Stevens EJ, et al. Is vaginal birth after caesarean (VBAC) or elective repeat caesarean safer in women with a prior vaginal delivery? Am J Obstet Gynecol. 2006;195(4):1143-7.

Loebel G, Zelop CM, Egan JF, Wax J. Maternal and neonatal morbidity after elective repeat Caesarean delivery versus a trial of labour after previous Caesarean delivery in a community teaching hospital. J Matern Fetal Neonat Med. 2004;15(4):243-6.

Sabol B, Denman MA, Guise JM. Vaginal birth after caesarean: an effective method to reduce caesarean. Clin Obstet Gynecol. 2015;58(2):309-19.

Abdelazim IA, Elbiaa AA, Al-Kadi M, Yehia AH, Sami Nusair BM, Faza MA. Maternal and obstetrical factors associated with a successful trial of vaginal birth after caesarean section. J Turk Ger Gynecol Assoc. 2014;15(4):245-9.