Publication:

To study the maternal and perinatal outcome following vaginal birth after caesarean section after one previous lower segment caesarean section

Background The pronouncement “Once a caesarean, always a caesarean” by Dr. Edward Craigen in 1916, established elective repeat caesarean section as standard of care. Over the years, there have been ample studies which have concluded relative safety of a vaginal birth in most women after a low transverse caesarean section. Hence vaginal birth after caesarean appears to be the most productive approach to lowering the caesarean rate. A prospective study was carried out to evaluate maternal and perinatal outcomes in patients undergoing VBAC with history of previous one LSCS.

Methods The study was undertaken in the department of Obstetrics and Gynaecology at Kasturba hospital, Delhi. Total of fifty cases of previous one LSCS who were eligible for vaginal deliveries were recruited and a prospective study was performed.

Results It was found that out of total fifty cases, 39 (78%) patients delivered vaginally and 11 (22%) patients had to be taken up for emergency LSCS for various indications. Significant association of success of VBAC was noted in patients with history of prior VBAC as compared to patients without history of prior VBAC (P value being <0.0001)There was more maternal and neonatal morbidity in case of failed VBAC as compared to successful VBAC. 18.1% neonates had NICU stay in Failed VBAC cases as compared to successful VBAC (2.56%).

Conclusions In carefully selected patients, under proper settings, VBAC can be safely practiced, thereby bringing down the rising caesarean rates.