Outcome of pregnancy in women with previous one cesarean section

Abstract

Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL.

Maternal Outcomes of Pregnancy in Women with Previous One C-Section in Qazi Hussain Ahmad Medical Complex, Nowshehra

“…152 participants were given a trial of labor among which 107(70.39 %) had successful VBAC and 45(29.61%) had repeat emergency C-sections. [17} As compared to this study our study showed a low VBAC percentage because all participants were not given a trial of labor [17]. In the Kingdom of Saudi Arabia, a retrospective Cohort study was conducted that was published in 2019 and had 299 women under study, 73.9% of the participants had successful vaginal births with no reports of any morbidity or mortality.…”

Pregnancy outcome in women with one previous caesarean delivery in Lagos University Teaching Hospital: A five-year review

“…Women with previous caesarean sections constitute a high risk group in obstetrics, because their pregnancy is associated with increased risk of maternal and fetal morbidity and mortality, during pregnancy, delivery and postpartum [2,3,4] . currently, women who will be allowed a VBAC must have fulfilled a certain criteria which included prior history of previous vaginal delivery with an average sized baby, women with interpregnancy interval of at least 15 months or inter-delivery interval of at least 24 months, non-recurrent indication in the previous delivery and no history of puerperal infection in the previous CS [2,3,6] .…”

“…The merits of vaginal birth following a caesarean abound: it affords the parturient the opportunity of self-fulfilment following a successful outcome, secondly it reduces the risks and morbidity associated with abdominal delivery-both anaesthetic risk and risk of surgery itselfthromboembolism, surgical site infection, increase cost of health care, less hospital stay. It therefore becomes imperative to assess the possibility of a vaginal birth following a previous caesarean delivery in pregnant women who meet the criteria [3,4] . This is even more important in low and middle income countries where greater premium is placed on large family size, and a sizeable percentage of the obstetrics population still have aversion for caesarean section [3,5] .…”

“…This is even more important in low and middle income countries where greater premium is placed on large family size, and a sizeable percentage of the obstetrics population still have aversion for caesarean section [3,5] . VBAC is currently been accepted in contemporary obstetric practice because of the significant improvement made so far on the type of uterine incision, choice of anaesthesia and development of more potent antibiotics, therefore, the phrase 'once a caesarean always a caesarean" no longer ~ 157 ~ applies [4,5] . This study therefore aims to determine the pregnancy outcome in women with one previous section at Lagos University Teaching Hospital.…”