Fetomaternal Outcome in Post Caesarean Pregnancy.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Introduction: One Of The Oldest Controversies In Obstetrics Is Over Optimal Management Of The Pregnant Women With Previous Lower Segment Caesarean Section (Lscs). With The Increasing Trends In Caesarean Section Rate A Large Expanding Population Of Women With Caesarean Sections Being Confronted With Various Problems In Their Future Pregnancies Particularly To Their Mode Of Delivery. There Are Conflicting Reports Regarding The Safety Of A Trial For Vaginal Birth After Caesarean Delivery (Vbac) In Terms Of Uterine Rupture, Maternal And Perinatal Morbidity. Aims And Objective: To Evaluate The Obstetric And Fetal Outcomes Of Women With Post Caesarean Pregnancy With The History Of Previous Lscs. Materials And Method: 541 Pregnant Women Admitted In The Labour Room Satisfying Inclusion Criteria Were Enrolled After Obtaining Their Consent For Participation For This Study, Which Is Done Over A Period Of 2 Years (Oct-2012 To Oct-2014) In The Department Of Obstetrics And Gynaecology , Vssimsar,Burla,Sambalpur. The Obstetric And Fetal Outcomes Of These Patients In The Present Pregnancy Were Noted And Tabulated. A Descriptive Analysis Of These Outcomes Was Carried Out. Results: 541 women with previous LSCS were studied. Of these, trial for a VBAC was attempted by 155 patients(women) and 96 (61.93%) had a successful VBAC. 309 (57.11%) women underwent emergency caesarean section & 77(14.23%) underwent an elective repeat caesarean delivery. 65.71% of the patients(women) who had a history of previous vaginal delivery (s) had a successful VBAC. Out of 18 patients(women) who were induced with PGE2 gel, only 4 (22.22%) delivered vaginally. Scar dehiscence was seen in 3.55% of the patients(women) who opted for a trial for VBAC. The birth asphyxia (APGAR < 8) was lower in cases of repeat caesarean delivery than in those who had a successful VBAC (5.84% Vs 6.25%). Maternal complications were also higher in patients who had a repeat LSCS compared to those who had a successful VBAC (18.61% Vs 6.25%).Average post partum hospital stay in VBAC group was 1.9 days in contrast to 8.5 days in repeat caesarean section(RCS)..Conclusion: As Pregnancy After Prior Caesarean Section Is In Increasing Trend , It Is Important To Provide Them Proper Antenatal Counseling Regarding Trial Of Labour After Caesarean Section (Tolac).Maternal Morbidity And Mortality Is Not Only Higher In Repeat Section But Also It Requires Prolonged Hospital Stay With Its Accompanying Expenditure Which Cannot Be Ignored In A Population Belonged To Low Socio Economic Group And A Successful Vbac Is Associated With A Lower Perinatal And Maternal Morbidity Than Repeat Caesarean Delivery. So A Well Defined Management Protocol Should Be Instituted In An Effort To Increase The Number Of Vbacs And Bring Down The Overall Caesarean Rates.
Authors and Affiliations
Dr. Kumudini Pradhan, Dr. Chintamani Mohanta, Dr. Priyamohan Jaysingh
Keywords
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- EP ID EP370548
- DOI 10.9790/0853-1704053646.
- Views 83
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