Review of outcome of pregnancy with history of previous caesarean section- predictors of safe labour
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
Objectives: To study the factors which affect outcome of trial of labor Materials and Methods: All pregnant women admitted to Goa Medical College, from October 2013 to June 2015, fulfilling the inclusion criteria were enrolled in this study. Data was collected in a proforma, meeting the objectives of the study. Antenatal/ past obstetric predictive factors with respect to successful TOLAC were analysed. Results: The study included 1,302 pregnant women with history of one or more previous cesarean deliveries, who fulfilled the inclusion criteria. 918 cases (70 %), including 236 subjects with previous 2 LSCS and 682 subjects with previous 1 LSCS; were taken for repeat LSCS (ERCD). Of the 384 cases (30 %) who underwent TOLAC; success rate was 80.5% (309/384). Younger women (<30 years) (OR=1.61,P= 0.0003),Women with BMI <25(P=0.03), IUGR babies(OR=1.38,P=0.63), Preterm gestation <37 weeks (P= 0.001), Low Birth weights (<3 Kg) (P=0.0045), a history of previous vaginal deliveries (P= 0.0014), Previous history of VBAC (P=0.018), Inter delivery interval >3 years of having a VBAC (OR=2,P=0.03), Bishops score at admission >/= 10 (P=0.000), Spontaneous onset of labour (P=0.034) were associated with significantly higher rate VBAC. Maternal diabetes (ODM/GDM) (OR=0.6,P=0.59), PROM (OR=0.39,P=0.013) previous LSCS was done for Cephalo-pelvic disproportion (OR=0.5) & Failure to progress (OR=0.29) reduces the chance of VBAC. Place of stay (P=0.75), Educational status (P=0.76), Pre-eclamsia (P=0.22) were not statistically significant factors affecting TOLAC. Conclusion: Positive predictors for VBAC from our study were younger age group, lower maternal BMI, absence of maternal diabetes, lower gestational age and birth weight, higher Bishops score at admission, spontaneous onset of labour, vaginal delivery prior to or after caesarean section, malpresentation as indication for prior LSCS and longer inter-delivery interval (>3 years).
Authors and Affiliations
Dr. Uma kamat, Dr. Taibai Gavde, Dr. K. Nithisha, Dr. Akshata Amonkar, Dr. Prajaktakatti, Dr. Nisha Naik, Dr. Anamika Mishra. , Dr. Guruprasad Pednecar
Keywords
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- EP ID EP421568
- DOI 10.9790/0853-1712011722.
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