Trial of labour after previous caesarean section: The predictive factors affecting outcome

Abstract

A prospective observational study was conducted at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, India on 300 pregnant women with one previous caesarean section fulfilling the eligibility criteria for trial of labour, to study the predictive factors and the outcome of trial of labour. The data obtained were analysed according to mode and outcome of labour and was then subjected to statistical analysis. The success rate of trial of labour was found to be 53.6%. Favourable Bishop's score (p = 0.000), spontaneous onset of labour (p = 0.005) and history of previous delivery after caesarean (p = 0.007) were significantly associated with a successful outcome of trial of labour. Higher chances of vaginal delivery were found with breech as an indication of previous caesarean section, i.e. 67.1% as compared to 39% with non-progress of labour as an indication.

Trial of Labor After Cesarean Section Among Women with Unique Lower Segment Scarred Uterus and Fetal Weight >3500 g: Prognostic Factors for a Safe Vaginal Delivery

“…Women who had vaginal delivery prior to (or after) the first CS had better chances (94.1 %) of successful TOLAC in our series, as noticed in Sweden and India, respectively [5,15]. This explains why women of parity C2 had better outcome of TOLAC than women of parity 1 in our series (P = 0.006).…”

Factors predicting success of trial of labour after caesarean in current scenario

“…67.1% as compared to 39% with non-progress of labour as an indication. 9 In our study, Repeat C.S. in failed TOL was performed for non-progress of labour (51%) as the most common indication being scar dehiscence in 41% cases followed by fetal distress being the second common indication.…”

Predicting the chance of vaginal delivery after one cesarean section: validation and elaboration of a published prediction model

“…To minimize negative outcomes for mothers and babies, the main issue would be to avoid planned vaginal deliveries ending in emergency CS [1][2][3][4][5][6]. Thus, a custom-built model for prediction of vaginal birth after cesarean (VBAC) would prove useful in pregnancies following one CS.Several models aiming to predict VBAC have been published [7][8][9][10][11][12][13][14][15][16][17]. Some models have been externally validated or supplemented with new variables in subsequent publications [2,[18][19][20][21].…”