Safety and perinatal outcome of trial of vaginal delivery after previous cesarean section - A study of 400 cases
Journal Title: Medpulse International Journal of Gynaecology - Year 2018, Vol 8, Issue 1
Abstract
Background: The National Institutes of Health Consensus Conference established that vaginal birth after cesarean section is an ‘acceptable choice.’ The recent dip in VBAC is due to various reports that have highlighted an increase in both maternal and fetal risks with VBAC including uterine rupture and perinatal deaths. Options available for woman with one previous cesarean section are either planned repeat cesarean section or trial vaginal delivery. In the present study we have attempted to look at the safety and perinatal outcome of VBAC after previous cesarean section. Aim of the Study: To compare the maternal morbidity in Vaginal births after cesarean sections (VBAC) with that of planned repeat caesarean sections and to study the perinatal outcome. Materials and Methods: A total of 400 women who had undergone previous caesarean section were selected for VBAC. Detailed clinical history was taken and examination was done. In intrapartum period close maternal and fetal monitoring was done. Oxytocin was used only for augmentation of labour. Maternal complications and perinatal outcome was noted. The study period was between January 2017 to September Observations and Results: A total of 14587 deliveries were conducted in the study period. Of these, vaginal deliveries were 10286 (70.5%) and lower segment cesarean sections (LSCS) were 4152 (29.6%).Gravida-2 women were 67.2%.Favorable cervical findings at the time of VBAC were present in 78.5% women. The scar dehiscence rate was 1.4%. Neonatal deaths were 0.5% and stillbirths were 1%. Conclusion: Vaginal birth after cesarean section (VBAC) can be integrated as a safe and acceptable option in all tertiary care centres and teaching hospitals. The scar dehiscence rate in our study was 1.5% which could be further reduced by better selection of cases. Favorable cervical score, average birth weight, smooth progress of labor, less need for augmentation of labor are indicators of a successful VBAC.
Authors and Affiliations
Kiranmai Devineni, A Mahita Reddy
Keywords
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- EP ID EP470447
- DOI 10.26611/1012813
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