ABSTRACT
Objective: to determine feto-maternal outcome and mode of delivery foliowing one previous caesarean section
Material and Methods: this descriptive study was conducted in department of Obstetrics and Gynaecology Unit-I Services Hospital, Lahore from June 2008 to June 2009. All patients with one previous caesarean section due to non-recurrent causes with spontaneous onset of labour at term were included in this study. Detailed clinical examination including abdominal and pelvic examination and ultrasound for fetal well being and placental localization were done. Progress of labour was monitored through Partogram. Fetal monitoring was done by auscultation and CTG
Results: Among 200 patients included in this study 66.5% had vaginal delivery while 33.5% had repeat caesarean section. Four scar dehiscence and one uterine rupture that was successfully repaired were noted. Common indications for repeat CS were failed progress and fetal distress
Conclusion: a trial of scar may be given in all pregnant women with previous caesarean section except those with absolute contraindications. A woman with one previous caesarean section delivery with low transverse incision should be counseled and encouraged to attempt labour in her current pregnancy in hospital with 24 hours facilities of Operation Theater and blood transfusion services
ABSTRACT
Abortion is a sensitive and contentious issue with religious, moral, cultural and political dimensions. It is also a public health concern in many parts of the world. An unsafe abortion is defined as a [Procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both]. The purpose of the present study was to determine the demographic variables, maternal morbidity and mortality in cases of unsafe abortion. The study was carried out with department of Obs. and Gynae., SIMS / Services Hospital, Lahore, as prospective observational. 87 women presented with complications of unsafe abortion. They were interviewed about their history, the clinical features, period of gestation, method used and qualification of abortionist. The details of management, complications and outcome were also analyzed. The age ranged from 15 to 45 years, teenagers accounted for 11.49% of patients. Mean age is 29 years. 20% were nulliparous and parity ranged between zero to eight. Mainly abortions were conducted by Dais [43%]. Contraception prevalence rate was just 8%. In 70% of patients surgical intervention was required and blood transfusion was needed in almost all patients. Maternal mortality was 16.09% with septicemia being the major cause. Unsafe abortion and its attendant complications is still a problem in Pakistan. Main reasons are unattended pregnancies, low contraception usage and late presentation to the health facilities