Maternal and perinatal outcomes of delivery after previous one or two cesarean section


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Article type :

Original Article

Author :

Kshama Vishwakarma, Gunjan Yadav, Parasuram Waddar

Volume :

7

Issue :

3

Abstract :

Introduction: The prevalence of cesarean deliveries is high in many parts of world. Vaginal birth after cesarean section (VBAC) is a trial of vaginal delivery in selected cases of a previous CS in a well equipped hospital. It offers distinct advantages over a repeat caesarean section, since the operative risks are completely eliminated, the hospital stay is much shorter and expenses involved are much less. Objectives: To study the maternal and perinatal outcomes among women with previous Cesarean section at a tertiary care centre. Materials and Methods: This prospective study was carried out over a period of 12 months. 979 pregnant women with previous caesarean section were recruited in study. A detailed history was taken and mode of delivery decided as per the standard protocol. 636 patients underwent elective repeat LCSC.343 patients were given trial of labour out of which 226 delivered vaginally. Maternal and neonatal outcomes were noted Result: The rate of successful VBAC was 65.89%. Most common indications of repeat caesarean section were fetal distress and failure to progress. Post op maternal and neonatal complications were significantly more in repeat caesarean section group. Incidence of infectious morbidity was also higher in repeat cesarean group than VBAC group. Conclusion: Fetal morbidity and mortality due to trial of labor is comparable with the women laboring without a scar, trial of labour may be encouraged. women given trial of labour with careful monitoring and taken for emergency LSCS on minimal indication is the best answer to management of previous one or two CS.

Keyword :

 VBAC, TOLAC, Emergency cesarean section, Perinatal morbidity.
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