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ObjectiveAfter globally acceptance of planned vaginal birth after cesarean section (VBAC), the mode of induction is still a matter of debate and requires further discussion. We aimed to study obstetric outcomes in post-cesarean patients undergoing induction of labor with prostaglandin gel compared with patients who developed spontaneous labor pains.MethodsAll patients at 34 weeks or more of gestation with previous one cesarean section eligible for trial of labor after cesarean section admitted in a labor room within one year were divided in 2 groups. Group one consisted of patients who experienced the spontaneous onset of labor pains and group 2 consisted of patients who underwent induction of labor with prostaglandin gel. They were analyzed for maternofetal outcomes. Descriptive statistics, independent sample t-test, and chi-square test were applied using SPSS 20 software for statistical analysis.ResultsBoth groups were comparable in maternal age, parity, and fetal weight, but different in bishop score, mode of delivery, and neonatal outcome. Admisson bishop score was 6.61±2.51 in group 1 and 3.15±1.27 in group 2 (P<0.005). In the patients who experienced spontaneous labor, 86.82% had successful VBAC. In the patients with induced labor, 64.34% had successful VBAC with an average dose of gel of 1.65±0.75. Both groups had one case each of uterine rupture. The neonatal intensive care unit admission rate was 4.1% in group one and 10.4% in group 2.ConclusionThis study reflects that supervised labor induction with prostaglandin gel in previous one cesarean section patients is a safe and effective option.

Objective: Pregnancy with an ovarian mass of 6 cm is a rare condition that sometimes goes unnoticed until term and, at times, leads to an acute surgical emergency. Torsion, rupture, fetal malpresentation, and obstructed labor are main associated complications. Materials and methods: This was a retrospective study of 14 cases of ovarian masses during pregnancy. All cases with persistent ovarian mass of 6 cm with pregnancy, presented symptomatically or asymptomatically, were included in the study. Patients' medical records were analyzed for general profiles, gestation age, clinical presentation, signs and symptoms, investigation, management, and neonatal outcome. Results: Mean age and parity in the study were 23.92 ± 3.91 and 2.14 ± 2.14 respectively. Only 35.71% were symptomatic, 11 (78.57%) patients were diagnosed with ultrasonography, and in 3 (21.43%), the diagnosis was made incidentally during lower segment cesarean section (LSCS). Patients were managed according to gestation age, presenting symptoms, and nature of mass. Cystectomy was done in 8 (57.14%) patients followed by salpingo-oophorectomy in 4 (28.57%) cases, and detorsion and cystectomy in 2 (14.28%) cases. On histopathology, serous cystadenoma was the most common type (42.85%) followed by dermoid cyst (28.75%), dysgerminoma (7.14%), and mucinous cystadenoma (7.14%). However, two cases could not be assessed due to gangrenous changes of masses. Emergency surgery was required in five cases of torsion; rest of the patients were taken for elective surgery. Conclusion: Pregnancy is a unique clinical stage with many physiological changes for the mother with her fetus in the womb. It is the maternofetal well-being that is of paramount importance in managing varied presentations of an ovarian mass in pregnancy.