Trial of labour after cesarean delivery: a study of 100 cases

ABSTRACT

To determine the outcome of trial of labour in patients with previous one lower segment cesarean section. Descriptive study. The study was conducted in the department of obstetrics and gynecology Nishter hospital Multan from July 2002 to December 2003. All patients with previous one cesarean section due to non recurrent cause admitted to the labour ward 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 was done. Progress of labour was monitored through partogram. Fetal monitoring was done by auscultation and cardiotocography [CTG]. Among 100 patients included in this study 69 [69%] had vaginal delivery while 31 [31%] had repeat cesarean section. Out of 69 patients 46 [66.66%] had spontaneous vaginal delivery, 12[17.39%] had Ventouse delivery and in 11[15.9%] patients outlet forceps were applied. Two [2%] had uterine rupture which were successfully repaired. Common indication for repeat cesarean section was failed progress of labour. This hospital based study shows that trial of labour in patients with previous one cesarean section due to non recurrent cause is safe and has success rate of 69% which is encouraging. It is therefore stated that vaginal birth after cesarean section[VBAC]should be offered to properly selected patients in hospitals with twenty four facilities of operation theater and blood transfusion services