DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204957

The clinical study of vaginal birth after caesarean section

Amarpali K. Shivanna, Spandana S., Rajani Vaidya

Abstract


Background: VBAC has reduced the rate of repeat caesarean section in modern medicine. VBAC-TOL is successful in 60-80% of acceptable candidates if applied to all patients presenting with prior caesarean procedure (8.2-8.5%), there is potential to increase the overall vaginal delivery rate by 5%. Though the safety of VBAC in carefully selected patients have been demonstrated in several studies, controversy continues over when to advise patients who had caesarean section to undergo TOL. The purpose of current study was to know the success of VBAC, to know the maternal morbidity and mortality and foetal outcome in VBAC group.

Methods: It was a prospective study performed on women with one previous LSCS admitted to tertiary care hospital for a period of one year from August 2018 to August 2019 at DM Waynad institute of medical sciences, Waynad.

Results: In the present study 292 women with one previous LSCS were selected, among them 32 women had elective LSCS for various indications, 260 women underwent TOL. Among 260 women, 152 women achieved VBAC (58.46%) and 108 women underwent LSCS following failed TOL. Maternal morbidity was 9.61%. The incidence of scar dehiscence was 2.69% and uterine rupture was 0.38%. There was no maternal and foetal mortality in this study. NICU admission was 4.6%.

Conclusions: Trial of labour should be encouraged in women with one previous LSCS with no obstetric complications.


Keywords


Trial of labour, Vaginal birth after caesarean section, Lower segment caesarean section

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References


Arulkumaran S, Ratnam SS, Rao BK. The management of labour. 3rd ed. India: Orient Blackswan; 2014.

Myerscough PR. Munro Kerr’s operative obstetrics. 13th ed. India: All India Traveller Book Seller; 2019.

Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Williams obstetrics. 25th ed. United States: Mc Graw-Hill; 2018.

Krishna U, Tank DK, Daftary S. Pregnancy at risk-current concept . 4th ed. India: Jaypee publisher; 2004.

Mark BL. Vaginal birth after caesarean delivery. Am J Obstet Gynecol. 2000;289:128-40.

Gabbe GS, Niebyl RJ, Simpson JL. Obstetrics-normal and problem pregnancies.7th ed. United Kingdom: Churchill Livingstone; 2017.

Demianczuk NN, Hunter DJ, Taylor DW. Trial of labour after previous cesarean section. Prognostic indicators of outcome. Am J Obstet Gynaecol. 1982; 142:640-2.

Agarwal A, Gupta HP, Anand S, Das K. Vaginal birth after caesarean–A partographic analysis. J Obst Gyn India. 2002;52:85-9.

Martin JN, Harris BA, Huddleston JF, Morrison JC, Propst MG, Wser WL, et al. Vaginal delivery following previous caesarean birth. Am J Obstet Gynecol. 1983;146:255-62.

Iyer S, Handa PR, Basu SB. Delivery after one previous caesarean section-one year prospective study. J obst Gyn India. 2001;51:51-4.

Elkousy MA, Sammel M, Stevens E, Peipert JF, Macones G. The effect of birth weight on vaginal birth after caesarean delivery success rate. Am J Obstet Gynecol. 2003;188:824-30.

Hibbard JU, Ismail MA, Wang Y, Te C, Karrison T, Ismail MA. Failed vaginal birth after a cesarean section: how risky is it? Maternal morbidity. Am J Obstet Gynecol. 2001;184(7):1365-71.

Landon MB, Hauth JC, Leveno KJ, atherine YS, Sharon L, Michael WV, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351:2581-9.

Smith GCS, Pell JP, Cameron AD, Dobbie R. Risk of perinatal death associated with labour after previous caesarean delivery in uncomplicated term pregnancies. J Am Med Assoc. 2002;87:2684-90.

Bujold E, Gauthier RJ. Neonatal morbidity associated with uterine rupture: what are the risk factors? Am J Obstet Gynecol. 2002;186:311-4.

Brein NO. Uterine rupture during VBAC trial of labour: risk factors and foetal Response. J Midwifery Wom Health. 2013;249-57.