No abstract

Patients' acceptance towards vaginal birth after Caesarean section (VBAC) was studied in 99 women with previous Caesarean section. Their attitude was strongly related to the chance of success of VBAC. Only 53.3% of patients would accept VBAC if they were told that the chance of success was 70%. A history of vaginal delivery and a negative feeling towards previous operation were positively associated with acceptance of VBAC (p < 0.01), while convenience of elective Caesarean section and fear of vaginal delivery (even although most of them had had no vaginal delivery before) were the commonest reasons for refusal. The major caused of a negative feeling towards the previous Caesarean section were postoperative pain and a long recovery period. There was no significant negative effect on acceptance of VBAC if the previous Caesarean section was performed as an emergency operation for slow progress of labour or cephalopelvic disproportion.

Two cases of ectopic pregnancy in the uterosacral ligament are presented. The cases are reported not only because of its rarity but also to arouse the thought of primary aetiology. With the increasing incidence of ectopic pregnancy due to assisted reproduction, gynaecologists are posed with the diagnostic challenge. The golden rule of management in extra-tubal pregnancy is to maintain high index of suspicion.

Single-dose prophylactic Augmentin did not produce any clinically significant improvement in the post-operative course of patients undergoing cesarean section. If proper surgical techniques are followed in association with closed rectus sheath drainage, it is unlikely that any trial of antibiotics will be able to demonstrate any clinically significant outcome.