Publication:

Induction of labor versus expectant management for women with a prior caesarean delivery

Background This study aimed to evaluate the feto-maternal outcomes in women with a previous caesarean section (CS) who underwent labor induction versus those managed expectantly. Vaginal birth after a caesarean (VBAC) has been associated with lower maternal morbidity, fewer fetal complications, shorter hospital stays, and fewer transfusions. While spontaneous labor may not always occur in these women, labor induction can be necessary for those attempting a trial of labor.

Methods This prospective randomized controlled trial was conducted in the department of obstetrics and gynaecology at Pt. BD Sharma PGIMS Rohtak over one year. 140 women with a history of previous LSCS were randomly divided into two groups: Group 1 received induction at 39 weeks, with monitoring and augmentation, if necessary, while Group 2 was managed expectantly until 41 weeks. The study aimed to compare the outcomes of induced labor versus expectant management in these women.

Results In our study, 37 women (52.8%) in the expectant management group went into spontaneous labor. Of these, 32 women (86.4%) delivered vaginally. In our study, the caesarean section rate was significantly higher (75.57%) when women were induced at 41 weeks compared to 39 weeks (40%). Fetal distress was the most common indication of caesarean section when the patient induced at 41 weeks.

Conclusions The study found that induction of labor in women with a previous caesarean section led to similar vaginal delivery rates as expectant management. No significant maternal or perinatal complications were observed, but close monitoring for fetal distress and scar rupture is essential.