Publication:

A study to evaluate feto-maternal outcome of trial of labour in previous cesarean patients: a prospective observational study at a tertiary care centre in India

Background Vaginal birth after cesarean section (VBAC) is associated with shorter maternal hospitalizations, less blood loss and fewer transfusions, and fewer thrombo-embolic events than cesarean section (C-section). A 60 to 70% success rate of vaginal birth after previous C-section has been reported by many authors if the primary cesarean was done for nonrecurring indications the subsequent pregnancyMethods: A prospective observational study was conducted at Sassoon general hospital, Pune, India. The 100 patients who fulfilled the inclusion criteria were studied. Maternal and fetal outcomes were analysed.

Results Out of the total 100 cases with previous C-section, successful vaginal delivery was possible in 65% cases. Most common reason for failed attempt to vaginal delivery was failure of labour to progress (40%) followed by failure of induction (28.6%) and non-reassuring FHR (22.9%). Out of the total 35 cases with gestation age over 40 weeks, 51.4% underwent C-section delivery as compared to 26.2% with gestation age of less than 40 weeks (p 25, gestation ≥40 weeks and history of previous emergency CS while high success rate was seen with history of any vaginal deliveries. We thus recommend that pregnant woman with history of C-section should be given the option of trial of labour after caesarean (TOLAC), unless contraindicated.