Abstract :
Introduction: Cesarean section rate has been on a continuous rise since 1970. When trial of scar is
done, 30- 80% of women with one previous lower segment caesarean section can achieve vaginal delivery.
Identification of the determinants of the success of TOLAC help in selecting the patients with favorable
factors and hence improving the success rate of TOLAC with minimum possible complications.
Materials and Methods: This study was planned from January 2015 to December 2015. Case files of
previous one cesarean pregnancies were reviewed retrospectively in two groups: VBAC group and RCS
group.
Results: There were 9.8% (N-488) previous one cesarean pregnancies out of which 67% (327) underwent
TOLAC. VBAC happened in 71.56% and RCS in 28.44%. Malpresentation, fetal distress, CPD and Failed
induction were the indications of primary cesarean which had significantly more number of VBAC as
compared to RCS (p value
the spontaneous onset of labour was compared to induced labour. The mean admission bishops score of
VBAC group was 6.952.72 and that of RCS group was 3.87 2.54 (p value- 0.000). Also the mean birth
weight of the VBAC group was 2.660.53 and that of RCS group was 2.800.47 (p value- 0.027).
Conclusion: Malpresentation, fetal distress, CPD and failed induction are the most important indications
of primary cesarean section which have better chances of VBAC. Spontaneous onset of labour, admission
bishops score and birth weight has significant affecton the outcome of TOLAC.
Keyword :
Trial of labour after cesarean (TOLAC), Vaginal birth after cesarean (VBAC), Repeat cesarean section (RCS), Previous one cesarean section, Determinants of success of TOLAC, Trial of labour after cesarean (TOLAC), Vaginal birth after cesarean (VBAC), Repe