A Study of Feto-Maternal Outcome in Cases of Vaginal Birth after Cesarean SectionA Study of Feto-Maternal Outcome in Cases of Vaginal Birth after Cesarean Section

Abstract

Introduction: Pregnancy with a previous cesarean section(CS) may lead to several concerning maternal, fetal, and neonatal complications in subsequent pregnancies such as placenta accreta and uterine rupture.Trial of labour after cesarean (TOLAC) and Vaginal Birth After Cesarean (VBAC) has a quantifiable effect on decreasing total cesarean deliveries. Aim: To assess maternal and fetal outcome of vaginal birth after one lower segment cesarean section in selected cases. Materials And Methods: Prospective observational study of maternal and fetal outcome included 100 ANC patients with singleton pregnancy of more than 34 weeks gestation and one previous lower transverse cesarean delivery admitted in SMIMER hospital between January 2018 to June 2019. Results: 57% patients had vaginal delivery without any assistance, while 18% patients required vacuum assistance and 25% patients required repeat LSCS after failure of TOLAC. Among successful VBAC none had any complications, while among repeated CS patients, 4% patients had PPH, 2%had intraoperative finding of uterine dehiscence and 1%had intraoperative finding of uterine scar rupture.67% had interval of ≤ 3 years between current and previous pregnancy. Bishop’s score of less than 8 resulted in 100% CS whereas Bishop’s score of more than 9 resulted in 100% VBAC.Among VBAC, 5.3% babies required NICU admission, while among repeated CS, 16% babies required NICU admission. Conclusion: This study has found a high success rate of VBAC (75%). Keywords: Vaginal birth after cesarean section; trial of labour after cesarean section.