F Perveen1, Q Shah. 1. Department of Obstetrics and Gynaecology, Dow Medical College and Civil Hospital, Karachi, Pakistan.
Abstract
OBJECTIVE: A prospective study was undertaken to evaluate the outcome of trial of labour (TOL) after one previous cesarean section. METHODS: A total of 2,447 deliveries were conducted during this study period over 22 months. Out of these patients 167 women had one previous cesarean birth, 112 (67.1%) of whom underwent trial of labour. RESULTS: Seventy-two (64.28%) of these patients achieved vaginal delivery. This success rate would be much higher if fixed protocol could be applied to all the patients. Fourty-six point fifteen percent of patients with past indication for cesarean section due to cephalopelvic disproportion also delivered vaginally. This advocates that each patient should be selected on individual merits and the past indication for cesarean section should be reviewed. One maternal death occurred in this study which was due to anaesthetic complication while the perinatal mortality rate in this group was slightly higher as compared to national perinatal mortality rate, reason discussed in the text. CONCLUSION: It is safe to offer TOL provided patient is carefully selected and monitored.
OBJECTIVE: A prospective study was undertaken to evaluate the outcome of trial of labour (TOL) after one previous cesarean section. METHODS: A total of 2,447 deliveries were conducted during this study period over 22 months. Out of these patients 167 women had one previous cesarean birth, 112 (67.1%) of whom underwent trial of labour. RESULTS: Seventy-two (64.28%) of these patients achieved vaginal delivery. This success rate would be much higher if fixed protocol could be applied to all the patients. Fourty-six point fifteen percent of patients with past indication for cesarean section due to cephalopelvic disproportion also delivered vaginally. This advocates that each patient should be selected on individual merits and the past indication for cesarean section should be reviewed. One maternal death occurred in this study which was due to anaesthetic complication while the perinatal mortality rate in this group was slightly higher as compared to national perinatal mortality rate, reason discussed in the text. CONCLUSION: It is safe to offer TOL provided patient is carefully selected and monitored.