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Background: Nowadays, cesarean sections are increasing consistently. Repeat cesarean sections are performed for a large percentage and associated with a higher rate of surgical complications and Long-term morbidities. The trial of labor after cesarean offers an alternative choice. This study carried out to assess the maternal and fetal outcome and to evaluate various parameters as a predictor of success of TOLAC.Methods: This prospective observational study conducted on 150 pregnant women with one previous LSCS who delivered at Mahatma Gandhi hospital, from January 2017 to July 2018. Patient having a singleton pregnancy, cephalic presentation, adequate pelvis size with spontaneous onset of labor were included. Cases were monitored carefully during the labor. Emergency LSCS was done if any indication appeared.Results: 78% of cases delivered safely by the vaginal birth and 22% of cases had an emergency repeat cesarean section (EmRCS). Favorable Bishop Score, active stage of labor and prior vaginal delivery were associated with higher success rate. One (0.66%) case of uterine scar rupture and 2 (1.33%) cases of scar dehiscence noted. No maternal mortality observed. Perinatal mortality occurred in 2 cases (1.33%).Conclusions: Present study shows that appropriate clinical settings and the properly selected group of patients can make the TOLAC safe and effective.
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Introduction: Sepsis is today’s overwhelming and lifethreatning response to infection and recent studies reveal thatserum cholesterol may be a useful prognostic marker of sepsis.Aim: To study the serum cholesterol levels in the patients ofsepsis and its prognostic significance.Material and methods: This was an Prospective Observationalstudy done at CSS Hospital, SVSU Subharti Medical CollegeMeerut U.P. 100 Patients qualifying by fulfilling all inclusionand exclusion criteria and were enlisted in the study afterinformed consent. Serum cholesterol levels were done on theday of presentation and the 3rd day.Result: In the instant study, out of 100 subjects, 48 showedthe rise in the cholesterol with sepsis where as in 52 subjectsshowed decline of cholesterol level. During the study, 52subjects survived whereas 43 subjects expired during thecourse of treatment, 5 subjects left the study group.Conclusion: Monitoring the total cholesterol level can beused as prognostic tool in ICU patients. The level of totalcholesterol at the time of presentation and then the trendwhich is followed by the total cholesterol (increasing trendin total cholesterol level indicates better prognosis of diseaseoutcome and vice versa), is a better marker for prognosis ofthe patient with septicemia in ICU patients