Evaluating trial of scar in patients with a history of caesarean section

Islam, Asif; Ehsan, Ayesha; Arif, Saadia; Murtaza, Javeria; Hanif, Atif

doi:10.4297/najms.2011.3201

Cited by 14 publications

(12 citation statements)

References 14 publications

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“…These findings are in agreement with some studies [19,24] and in conflict with others [25] that demonstrated a higher rate of adverse neonatal outcome in association with failed trial of scar, nonavailability of modern neonatology equipment, or increased uterine rupture rate.…”

Section: Discussionsupporting

confidence: 93%

Induction of labor in patients with previous cesarean section using two different forms of vaginal dinoprostone

Hassan¹

2016

Evidence Based Womenʼs Health Journal

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BackgroundInduction of labor (IOL) in women who have undergone a prior cesarean section (CS) is an alternative to mitigate subsequent CS. The aim of this study was to evaluate the efficacy and safety of two different forms of vaginal dinoprostone (1.5 and 3 mg vaginal tablets) for IOL in patients who have undergone one previous CS. Materials and methodsThis pilot study was conducted in Minia University Hospital, Egypt. Eighty pregnant women who had undergone one previous CS were randomized to receive vaginal dinoprostone 1.5 or 3 mg for IOL. The outcome measures were compared. Results Use of dinoprostone 3 mg was associated with higher number of vaginal delivery, less oxytocin use, and shorter induction-delivery interval compared with 1.5 mg dose. The differences were not statistically significant. Out of 80 patients planned for IOL, 52 (65%) delivered vaginally and 28 (35%) underwent a CS. Maternal morbidity did not differ significantly between the two groups. Uterine dehiscence was diagnosed in only one patient (1.2%). Three cases had atonic postpartum hemorrhage. ConclusionThe two forms of dinoprostone vaginal tablets had comparable efficacy and safety profile when used for IOL in women who had undergone a previous CS. A larger, multicenter, randomized, controlled study is recommended.

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Section: Discussionsupporting

confidence: 93%

Induction of labor in patients with previous cesarean section using two different forms of vaginal dinoprostone

Hassan¹

2016

Evidence Based Womenʼs Health Journal

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“…These findings are in agreement with some studies [28,29,33,37], but disagree with others [6,32] that demonstrated a higher rate of adverse neonatal outcome in association with a failed trial of scar, non-availability of modern neonatology equipment, or increased uterine rupture rate.…”

Section: Commentssupporting

confidence: 84%

“…Vaginal birth after cesarean section (VBAC) is settled from the 1980 National Institutes of Health (NIH) Consensus Conference on Cesarean as a tool to minimize the cesarean delivery rate [5]. The present medical studies show that 60% -80% of women can attain successful trial of labor after a previous cesarean section [6].…”

Section: Introductionmentioning

confidence: 99%

Comparative study for success rate of vaginal birth after cesarean section following labor induction by two forms of vaginal dinosprostone: A pilot study

Hassan¹,

El-Tohamy²

2014

OJOG

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Background: Cesarean delivery has become the most common major surgical procedure in many parts of the world. Induction of labor in women with prior cesarean delivery is an alternative to mitigate the rising cesarean rates. Objectives: To compare the VBAC success rate between two vaginal forms of dinoprostone for labor induction in women with prior cesarean section. Material and Methods: A pilot study was conducted at a large Governmental Hospital, Dhahran, Saudi Arabia, including 200 women with prior cesarean section and planned for labor induction. Participants were randomly allocated into two groups. Group A (n = 100) received dinoprostone 1.5 mg vaginal tablet. Group B (n = 100) received 10 mg dinoprostone sustained release vaginal pessary. Primary outcome was vaginal delivery rate. Secondary outcomes included maternal and neonatal outcomes. Results: The dinoprostone vaginal tablet and dinoprostone vaginal pessary had a comparable vaginal delivery rate (67% and 64%, respectively; p = 0.78). The median patient satisfaction with the birth process was superior in the dinoprostone vaginal pessary group (p = 0.04). Maternal and neonatal outcomes were similar in both groups. Conclusion: Both forms of dinoprostone were effective methods for labor induction in women with prior cesarean section. However, the patient satisfaction with the birth process was in favor of the dinoprostone sustained release vaginal pessary.

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“…The low transverse incision has approximately 0.2%-0.5% incidence of uterine rupture with VBAC. 6 For success of VBAC, scar rupture should be anticipated. Use of obstetric risk assessment before trial of scar, continuous electronic fetal heart rate monitoring and intrauterine pressure monitoring during labor will help in anticipation.…”

Section: Introductionmentioning

confidence: 99%

“…Late signs include cessation of uterine activity, hematuria, loss of station of the presenting part and maternal shock. 6 The subject of the delivery of a woman after a previous one cesarean section remains controversial. However, we should keep in mind that patients with successful trial of labor experience fewer complications like blood transfusions, postpartum infections and no increase in perinatal mortality as compared to those with planned repeat caesarean delivery.…”

Section: Introductionmentioning

confidence: 99%

Intra-operative uterine scar condition and fetomaternal outcome in patients of previous lower segment caesarean section (LSCS) with scar tenderness

Gupta

Sinha²

2017

Int J Res Med Sci

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Background: During past few years, there is increasing trend in trial of labor in cases of previous lower segment caesarian section (LSCS). It needs vigilant approach in identifying signs and symptoms of giving way of previous scar. This study is to see the intra-operative uterine scar condition and feto-maternal outcome in patients of previous LSCS with scar tenderness.Methods: This is a prospective study done in Safdarjung hospital, New Delhi. It includes 120 patients of previous lower segment caesarian section with scar tenderness operated as emergency cases over a period of one year. It excludes elective repeat LSCS.Results: During this period repeat emergency LSCS was done in 862 cases and scar tenderness was seen in 120 cases (13.92 %). Out of 120 cases enrolled for the study intra-operative scar was intact in 69 cases (57.5%). Scar was thinned out in 27 cases (22.5%). Scar dehiscence was found in 21 cases (17.5%). Rupture occurred in 3 cases (2.5%) out of which 2 were Fresh still births. NICU admission was done in 11 cases (9.17%). 1 neonatal death occurred. No maternal death was recorded. Average hospital stay was 6 days. Blood transfusion was needed in 23 cases (19.2%).Conclusions: Scar tenderness is a very important tool for predicting scar integrity. All cases of previous LSCS should have institutional delivery.

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Evaluating trial of scar in patients with a history of caesarean section

Cited by 14 publications

References 14 publications

Induction of labor in patients with previous cesarean section using two different forms of vaginal dinoprostone

Induction of labor in patients with previous cesarean section using two different forms of vaginal dinoprostone

Comparative study for success rate of vaginal birth after cesarean section following labor induction by two forms of vaginal dinosprostone: A pilot study

Intra-operative uterine scar condition and fetomaternal outcome in patients of previous lower segment caesarean section (LSCS) with scar tenderness

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