INTRODUCTIONCesarean section is one of the most commonly performed abdominal operations on women in most countries. Cesareans section aims at reducing maternal and fetal mortality and morbidity by virtue of its cautions and careful approach. In many countries, C-sections have become the mode of delivery in over a quarter of all the birth. The World Health Statistics (WHS), 2012, released on Wednesday, said 9% of all births in India were by Caesarian section. The latest figure has gone up by 5% since nearly one in 10 women in India, who gave birth between 2005 and 2010, had gone under the surgical knife.1 Using the data of national family health survey India (1992-93) Mishra and Ramanathan found that among 18 large states two states has CS rate near 15 percent and the rest had less than 5 percent. ABSTRACTBackground: Cesarean section is one of the most commonly performed abdominal operations on women. Because of increasing incidence of Cesarean sections the no. of patients with previous 1 LSCS is also increasing. Thus proper antenatal counseling and institutional delivery should be done. Methods: A prospective observational study was conducted at department of Obstetrics and Gynaecology, LLRM Medical College Meerut during one year period from Nov 2015-May 2016. Participants to study the maternal and fetal outcome in pregnant women with previous one LSCS. 200 pregnant women were included in the study and outcomes were studied. Results: Maternal Outcome: Out of 200 cases 122 patients underwent vaginal birth after Cesarean (VBAC) accounting for 61% and 78 patients underwent 2nd LSCS (76 emergency LSCS and 2 elective LSCS). Out of 76, 55 patients were given trial of VBAC but failed and end up in C-Section showing success rate of 68.92% for VBAC (122 out of 177). Adhesions were found in 21patients out of 78 (26.92%) who underwent LSCS. Uterine rupture seen in 2 patients out of 200 cases (1.0%). Scar dehiscence was seen in 6 out of 78 patients (7.69%). Post-partum Hemorrhage was seen in only 20 (10%) patients. Pre-term Pregnancy occurred in 16 (8%) patients. Caesarean Hysterectomy had to be done in 3 (1.5%) patients. Placenta Previa was seen in 6 out of the 200 patients (3%) and placenta accrete was seen in 1 patient (0.5%). Out of 200 patients, 2 twins were born. The total number of babies born was 201. 8 IUDs occurred out of 201 babies (3.98%) and a total of 25 out of 193 live babies (12.95%) required admission to Neonatal Intensive Care Unit out of which 2 babies died. Conclusions: Cesarean section should not be always followed by a repeat cesarean section. Patient should have hospital delivery in a well-equipped hospital and complications should be diagnosed at an early stage so that maternal and perinatal morbidity and mortality could be prevented.

Uterine rupture is a dreaded catastroph in obstetrics with a high incidence of maternal and fetal morbidity. In developing Country, the overall prevalence widely varies from 1 in 2,000 to 1 in 200 deliveries. Uterine rupture in an unscarred uterus is a rare event and only a finger countable cased have been reported on posterior rupture of uterus in unscarred uterus. We here presenting a case of spontaneous posterior rupture of an unscarred uterus. Our patient was 38 years old grand multipara, a 6th gravida female with 4 parity, 1 abortion last year and 3 live issues. She was 9 months of gestation with previous all normal vaginal deliveries. This time she had a uterine rupture in the lower segment of posterior wall of uterus during labour. The rupture was unrepeatable, so we have to do hysterectomy. This case points out to keep this catastroph in mind in multiparas with unscarred uterus and to be prepared for the same while assisting a normal vaginal delivery.