Lekshmi Balachandran1, Pooja R Vaswani2, Ramakone Mogotlane3. 1. Clinical Associate Professor, Department of Obstetrics and Gynaecology, Amritha institute of Medical Sciences , Kochi, Kerala, India . 2. Specialist, Department of Obstetrics and Gynaecology, Madinat Zayed Hospital , Abudhabi, UAE . 3. Consultant, Department of Obstetrics and Gynaecology, Cape Town, South Africa .
Abstract
OBJECTIVE: The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section in relation to vaginal delivery and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of scar (TOS). MATERIALS AND METHODS: A retrospective analysis of medical records of 151 women with previous one cesarean section who delivered at the Mafraq Hospital, Abu Dhabi between January-August 2011was carried out. Those women with previous classical cesarean section and those with extreme prematurity were excluded. The collected data were analyzed using SPSS software version 20. Continuous and categorical data were presented in the form of mean, standard deviation and percentage, while proportions were analyzed using the chi-square test. A p-value ≤0.05 was considered statistically significant. RESULTS: Of the 151 women, 115 were candidates for TOS. Of them, 96 (83.47%) had vaginal birth after cesarean (VBAC) and 19 (16.5%) had a repeat cesarean section. There were four cases of primary postpartum hemorrhage (PPH) and two cases of scar dehiscence in the study group. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC. CONCLUSION: 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.
OBJECTIVE: The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section in relation to vaginal delivery and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of scar (TOS). MATERIALS AND METHODS: A retrospective analysis of medical records of 151 women with previous one cesarean section who delivered at the Mafraq Hospital, Abu Dhabi between January-August 2011was carried out. Those women with previous classical cesarean section and those with extreme prematurity were excluded. The collected data were analyzed using SPSS software version 20. Continuous and categorical data were presented in the form of mean, standard deviation and percentage, while proportions were analyzed using the chi-square test. A p-value ≤0.05 was considered statistically significant. RESULTS: Of the 151 women, 115 were candidates for TOS. Of them, 96 (83.47%) had vaginal birth after cesarean (VBAC) and 19 (16.5%) had a repeat cesarean section. There were four cases of primary postpartum hemorrhage (PPH) and two cases of scar dehiscence in the study group. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC. CONCLUSION: 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.
Entities:
Keywords:
Elective Repeat cesarean section; Trial of labour; Trial of scar; VBAC
Authors: Mark B Landon; John C Hauth; Kenneth J Leveno; Catherine Y Spong; Sharon Leindecker; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary Jo O'Sullivan; Baha Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer; Steven G Gabbe Journal: N Engl J Med Date: 2004-12-14 Impact factor: 91.245
Authors: George A Macones; Jeffrey Peipert; Deborah B Nelson; Anthony Odibo; Erika J Stevens; David M Stamilio; Emmanuelle Pare; Michal Elovitz; Anthony Sciscione; Mary D Sammel; Sarah J Ratcliffe Journal: Am J Obstet Gynecol Date: 2005-11 Impact factor: 8.661
Authors: Mohammed A Elkousy; Mary Sammel; Erika Stevens; Jeffrey F Peipert; George Macones Journal: Am J Obstet Gynecol Date: 2003-03 Impact factor: 8.661
Authors: Ibrahim A Abdelazim; Assem A M Elbiaa; Mohamed Al-Kadi; Amr H Yehia; Bassam M Sami Nusair; Mohannad Abu Faza Journal: J Turk Ger Gynecol Assoc Date: 2014-12-01
Authors: K Zh Sakiyeva; Ibrahim A Abdelazim; M Farghali; S S Zhumagulova; M B Dossimbetova; M S Sarsenbaev; G Zhurabekova; S Shikanova Journal: J Family Med Prim Care Date: 2018 Nov-Dec