Vaginal Birth After Previous One Caesarean Section in a Private Teaching Hospsital

Abstract

Objectives: The objective of the study was to assess the factors indicating success in vaginal delivery after previous one C-Section.
 Material and Methods: The study was carried out to assess the factors indicating successful VBAC ( vaginal birth after caesarean section). Over a period of two years from Jan 2011 to Dec 2012 at the department of Obstetrics and Gynecology Al-khidmat Teaching Mansoorah Hospital, Lahore affiliated with University College of Medicine and Dentistry
 Results: The frequency of normal vaginal delivery after previous 1 C-Section was 47.29% while 52.7% had repeat CSection. The only statistically significant factor which could favor successful vaginal delivery was history of previous vaginal delivery prior to previous C-Section. Patients who had previous C-section for bad obstetrical history were delivered by repeat caesarean section. Majority of the patients included in the study group were booked belonged to educated middle class families having awareness of the complications that may occur during trial of labor. Provision of adequate antenatal health care services, timely identification of high risk cases, use of electronic fetal monitoring, involvement of senior , skilled and experienced personnel in the management of obstetrical emergencies are responsible for successful trial of Labor i.e. almost 50% patients delivered vaginally after previous I C-Section. Thus in order to increase the rate of NVD frequency of trial of labor must be increased with the goal of vaginal delivery but without compromising maternal and fetal health.
 Conclusion: Almost 50% of the patients with previous one C-Section can be delivered normally especially if they had delivered vaginally previously. The decision of VBAC is complex and ultimately resides with the women and her Obstetrician after counseling the patient regarding all the risk - benefit profile.