Vaginal birth after cesarean section

ABSTRACT

A study of 254 deliveries in women with previous caesarean section was undertaken to evaluate the safety or otherwise of trial of labour. Elective repeat caesarean section was performed in 114 [45%] cases, while 140 [55%] cases were allowed a trial of labour. Out of these, 73 [52%] cases were successful in achieving vaginal delivery. There was one maternal death [4/1000] in elective caesarean section group. The estimated perinatal mortality was 75/1000 in this study. Five cases [20%] of scar rupture were encountered in these women and three of them ruptured before admission to the hospital. The perinatal mortality was significantly increased in cases with scar rupture. It is concluded that proper antenatal surveillance and timely admission to the hospital is essential is these cases to prevent catastrophes. Each women with a previous caesarean scar must deliver in a hospital in her subsequent delivery. Every effort should be made to educate the patient in this regard