Objective: To assess the effect of date fruit consumption in late pregnancy on the onset and progress of labour, the need for induction and augmentation, and delivery outcomes. Study Design: Randomized controlled trial (NCT05105893). Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2021. Methodology: One hundred and forty women were randomized into equal-strength Experimental and Control Groups (70 in each Group). The Experimental-Group included those pregnant females who were advised to consume seven dates per day from 35 weeks onwards till the spontaneous onset of labour. In contrast, the Control-Group comprised primigravidae who did not consume dates in later pregnancy. Results: Spontaneous onset of labour was reported in 59(84.2%) pregnant women of the Experimental-Group compared to 43(61.4%) of Control-Group. 55(78.5%) pregnant women who consumed date fruit had a spontaneous vaginal delivery,4(5.7%) required instrumental delivery, and 11(15%) ended up having a caesarean section, whereas 43 out of 70(61.4%) women of the Control-Group had a spontaneous vaginal delivery, 6(8.5%) had an instrumental vaginal delivery, and 21(30%) underwent a cesarean section. Conclusion: The patients who had consumed date fruit in later pregnancy had an improved Bishop score at the onset of labour, a shorter duration of labour, a lesser need for induction and augmentation of labour and more spontaneous vaginal deliveries.

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Objective: To determine the effect of short inter-pregnancy interval on the outcome of vaginal birth after cesarean section. Study Design: Comparative cross-sectional study. Place and Duration of Study: Obstetrics and Gynecology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2021. Methodology: A total of 400 pregnant females were selected for this study. For every consecutive pregnant woman with a previous cesarean section and short inter-pregnancy interval (<18 months) recruited into the study, a suitable control with inter-pregnancy interval ≥18 months were recruited. Results: Only 107(53.5 %) females with short interpregnancy interval had a successful vaginal birth after cesarean section, whereas 143(71.5 %) females with >18 months’ inter-pregnancy interval had a successful VBAC. In patients with a history of vaginal delivery, the success of vaginal birth after the cesarean section was significantly higher than in those without previous vaginal delivery or VBAC (p=0.005). 231 out of 250(92.4%) pregnant females with spontaneous onset of labour had a successful VBAC compared to those who had induction of labour, 19(7.6%) (p=0.005). Patients who needed augmentation during delivery had a higher rate of undergoing a cesarean section than VBAC (p=0.003). However, no significant difference was observed in the spontaneous onset of labour and the need for induction and augmentation of labour for the inter-pregnancy interval. Conclusion: Our study concluded that with increasing inter-pregnancy interval, the chances of a successful VBAC increase (p=0.001) with fewer reported complications.