Review of Study of Vaginal Birth After Caesarean Section (VBAC)

Abstract

Aims and Objectives: To determine the frequency and mode of delivery in women with one caesarean section and to evalu-ate the fetomaternal outcome of trial of labour of previous one caesarean section.

Material and Methods: A trial of vaginal delivery was carried out on 100 patients in the Department of Obstetrics and Gynaecology of Lahore General Hospital Lahore, Descriptive study was conducted from September 2006 to September 2007. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions, vertex presentation and spon-taneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complica-tions, multiple pregnancy, 1UGR, placenta previa and extensive myomectomy were excluded from the study. Informed con-sent was taken from all patients; trial of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anesthesia and pediatrician.

Results: Success vaginal delivery was achieved in 70% of the patients and repeat emergency caesarean section was carried out in 30% of the patients. Leading indication for repeat caesarean section was failure to progress, fetal distress and scar ten-derness. No maternal and fetal complication occurred.

Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contra-indication exists.

Key words: VBAC, scar tenderness, maternal mortality, LSCS.