Two uterine scars and a vaginal birth

2021 ◽  
Vol 14 (1) ◽  
pp. e236993
Author(s):  
Christine Wu ◽  
James Christie ◽  
Roshini Nayyar
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Uterine Rupture ◽  
Vaginal Birth ◽  
Morbidity And Mortality ◽  
Normal Vaginal Delivery ◽  
Uterine Perforation ◽  
Previous Caesarean Section ◽  
Insufficient Evidence ◽  
History Of

Uterine scarring increases the risk of uterine rupture during labour, which can result in significant maternal and fetal morbidity and mortality. There is insufficient evidence for a clear recommendation on the safety of vaginal delivery in the context of a patient with both a uterine perforation and a previous lower uterine segment caesarean section. We present the case of a woman with a history of one previous caesarean section and uterine perforation with a uterine manipulator, who subsequently had an uncomplicated normal vaginal delivery.

scholarly journals Vaginal birth after caesarean section: why and how?

2017 ◽  
Vol 6 (12) ◽  
pp. 5554
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit Gavhane ◽  
Vishesha Yadav ◽  
Kunal Aher ◽  
Dhruval Bhavsar
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Maternal Complications ◽  
History Of ◽  
Spontaneous Onset ◽  
Vaginal Birth After Caesarean

Background: With the significant rise in the incidence of primary caesarean section(CS) for various indications, an increasing proportion of the pregnant women coming for antenatal care, report with a history of a previous CS. This necessitates definite need to bring down the caesarean section rate, either by judicious selection of cases for primary caesarean section or by attempting vaginal delivery, following previous caesarean section (VBAC).Methods: A prospective observational study was conducted to find out the success of VBAC and the common predictive factors leading to successful VBAC. A total of 136 pregnant women with full term pregnancy, having history of previous one lower segment caesarean section and without any other medical and obstetrical complication were enrolled in the study.Results: Majority of the women (95.59%) had spontaneous onset of labor. The success of VBAC was 75 percent. The commonest maternal complications were fever (7.35%), scar dehiscence (3.68%), PPH (1.47%) and wound infection (2.21%).There was significantly higher number of women who had history of previous successful VBAC, had vaginal delivery (91.67%; p=0.038).It was observed that the rate of vaginal delivery was significantly high in women with Bishop’s score between 10 to 13 (94.64%) compared to 6 to 9 (61.25%) (p<0.001).The baby weight determined by ultrasound scan was significantly associated with mode of delivery (p=0.049).Conclusions: Vaginal Birth After Caesarean section is relatively safe, provided it is conducted in carefully selected cases, under constant supervision. Spontaneous onset of labour, good Bishops score and average baby weight were good predictors of successful VBAC.

scholarly journals Obstetrical outcome in post caesarean pregnancy

2018 ◽  
Vol 7 (11) ◽  
pp. 4561
Author(s):  
Anitha Aldur Manjappa ◽  
Soundara Raghavan Subrahmanian
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Clinical Situation ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Success Rates ◽  
Vaginal Deliveries ◽  
History Of ◽  
Obstetrical Outcome

Background: Rates of caesarean delivery have increased over past 40 years. The increase has been attributed to liberalization of indications for caesarean sections. Repeat caesarean section is a major contributor to caesarean rates; Vaginal Birth After Caesarean (VBAC) is one of the methods to contain increasing caesarean rates. Success rates of 60-80% have been reported.Methods: This was a descriptive study involving 1000 pregnancies of period of gestation more than 28 weeks with history of one previous caesarean section. The women under study were subjected to either trial vaginal delivery or elective repeat caesarean delivery depending upon the clinical situation. The percentage of successful vaginal deliveries, factors responsible for failure of vaginal delivery and differences in outcome between successful vaginal delivery and caesarean delivery group were analyzed.Results: Out of the 1000 women, 423 underwent elective repeat caesarean delivery, of the remaining 577, 403 (69.8%) had successful vaginal delivery. Age of the woman and onset of labour were the only factors influencing the success of vaginal delivery. Women aged 35 years or more and women who needed labour induction had lower success of vaginal delivery. Maternal and perinatal outcome were worse in failed vaginal delivery group when compared to elective repeat caesarean delivery or successful vaginal delivery groups.Conclusions: Factors which are usually thought to influence the decision about trial vaginal delivery like prior vaginal delivery, indication for previous caesarean section and interpregnancy interval are not absolute in determining the decision or the outcome. Labour induction should be resorted with great caution in women with post caesarean pregnancy.

scholarly journals Spontaneous Vaginal Delivery after Three Previous Caesarean Sections

2018 ◽  
Vol 1 (1) ◽  
pp. 120-124
Author(s):  
Hani Shams Eldin ◽  
Nicholas Oligbo
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Uterine Rupture ◽  
Elective Caesarean Section ◽  
Vaginal Birth ◽  
Spontaneous Vaginal Delivery ◽  
Mortality And Morbidity ◽  
Risk Increase ◽  
Wheel Chair ◽  
Uterine Scar

Women with one previous caesarean section have 0.05% risk of uterine rupture, with two caesarean sections the risk increase to 1.36%. We could not find data on the risk of uterine rupture after three caesarean sections. Elective caesarean section is therefore offered to these women by their clinical professionals to eliminate the risk. However, we report a case of spontaneous vaginal delivery with an intact uterine scar in a woman with a previous three caesarean sections to show the possibility of vaginal birth in patients with repeated caesarean section. A 32-year-old female in her 4th pregnancy with previous three caesarean section 1st two emergencies and 3rd elective (Gravida 4, para 3) presented to the delivery suite in spontaneous labour at 39 weeks and 3 days with vaginal bleeding. Emergency call gone off and patient was transferred immediately to theatre, during transfer she pushed down while she was on the wheel chair and the baby head found to be delivered vaginally. A live healthy baby girl weighing 2590 g was delivered. The patient had Postpartum bleeding of 500 ml and 2nd degree perineal and labial tears; the patient was discharged home fit and well on day one postpartum. Repeated caesarean section increases maternal mortality and morbidity. Vaginal birth after repeated previous caesarean sections could still be an option in selected cases as safe vaginal delivery has been reported.

scholarly journals Indication and Outcome of Caesarean Section in Multigravid Women with a History of Vaginal Delivery in a Tertiary Care Hospital

2020 ◽  
Vol 14 (2) ◽  
pp. 86-89
Author(s):  
Poly Begum ◽  
Dipti Rani Saha ◽  
Dilruba Zeba
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Delivery Outcome ◽  
History Of

It is commonly believed that if the first child of a mother is born by normal vaginal delivery, all the subsequent deliveries will follow the same. As a result, such multiparous mothers often neglect routine antenatal check ups and intranatal care which may cause poor delivery outcome. For these reasons, attention should be given to analyze the indication of caesarean section (CS) in women who had history of previous vaginal delivery. Our objective was to know the indications and outcome of CS in multigravid women having a child previously delivered vaginally. This observational cross-sectional study was carried out in the Department of Obstetrics and Gynaecology in Diabetic Association Medical College Hospital, Faridpur. One hundred and ten multigravid women who had undergone elective as well as emergency CS for various indications were included in this study. Most common indication of CS was fetal distress (33.64%). Others were obstructed labour (10.9%), breech presentation (10.9%), and pre-eclampsia (9.09%). In the postpartum period, 75.5% patients were healthy. Others developed sepsis (10.9%) and URTI (8.2%). Most of the babies (95.5%) were alive. Understanding these insights may help both the mother and the caregiver an idea about the associated risks and what actions should be taken for a safe delivery outcome. Faridpur Med. Coll. J. Jul 2019;14(2): 86-89

scholarly journals Prelabour Uterine Rupture In Two Patients With A Previous Caesarean Section For Placenta Previa

2020 ◽  
Author(s):  
Miriam Dellino ◽  
Francesco Maria Crupano ◽  
Xuemin He ◽  
Antonella Vimercati
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Pregnancy Complication ◽  
Previous Caesarean Section ◽  
Careful Evaluation ◽  
Spontaneous Uterine Rupture ◽  
History Of

Abstract Background Spontaneous uterine rupture is a severe pregnancy complication. Several risk factors have been described, especially for women with a previous caesarean section.Method We reported two cases of uterine rupture (UR) occurred outside of labour in patients with a history of caesarean section for placenta previa were reports. Results The current study evaluates how a higher hysterotomy, combined with some risk factors, can increase the prevalence of UR in the next pregnancy. Conclusion These cases presentation provide a supplement to over-all knowledge about UR showing that a careful evaluation of risk factors could promote the early UR management and consequently, improve the maternal-fetal outcome.

scholarly journals Risk of uterine rupture in women undergoing trial of labour with a history of both a caesarean section and a vaginal delivery

2011 ◽  
Vol 284 (5) ◽  
pp. 1053-1058 ◽  
Author(s):  
Hinke de Lau ◽  
Hendrik Gremmels ◽  
Nico W. Schuitemaker ◽  
Anneke Kwee
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Uterine Rupture ◽  
History Of

scholarly journals The Outcome of Vaginal Birth After One Caesarean Section (VBAC)

2020 ◽  
Vol 39 (1) ◽  
pp. 36-45
Author(s):  
Mst Jesmin Akter ◽  
Eliza Shirin
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Multiple Pregnancy ◽  
Vaginal Birth ◽  
Fetal Survival ◽  
History Of

Background: Caesarean section has become the most performed major operation in obstetrics. The increasing rate of primary caesareans section becomes high worldwide due to early detection of fetal and maternal complications. Repeated caesarean section is one of the major contributory factors for increasing this rate very significantly. Now a day, vaginal delivery of pregnant mothers with the history of previous one caesarean with non-recurrent cause was established. It has been shown that the outcome of trial of labor in past caesarean delivery is acceptable, effective and safe for both mother and fetus, if the women are properly selected. Objective: The objectives of this study were to determine the outcomes of vaginal birth after caesarean section (VBAC) in case of previous one caesarean section to reduce the subsequence cesarean section with its complication. Materials and Methods: It was a cross sectional study carried out in the Maternity Unite-1, Department of Gynecology & Obstetrics, Sir Salimullah Medical College and Mitford hospital, Dhaka, Bangladesh, held on January 2010 to December 2010. Out of total 380 admitted pregnant women who had previous one caesarean section, 50 pregnant women of 37-42 weeks of gestational age with the history of one caesarean delivery with alive baby were selected as study population following consecutive and purposive sampling method. Patients with spontaneous onset labor but preterm pregnancy with any contraindication or prior caesarean section due to recurrent causes, history of classical caesarean section, more than one caesarean section, multiple pregnancy, pregnancy with medical disorder were excluded in the study. Results: Out of total 50 sampled pregnant women, vaginal delivery were done 16(32%) & emergency cesarean section were done 34(68%). According to the age group both vaginal & cesarean section 20- 30 years were predominant, which were 8(50%) and 17(50%) respectively. Regarding antenatal care 13(81.25%) of vaginal delivery cases were regular. On the other hand, only 10(29.41%) of cesarean section were regular in care. Fetal survival outcome in vaginal & caesarean were 14(87.5%) and 33(97.05%) respectively. Comparing the maternal complication maximum number of vaginal delivery group had no complications. Conclusion: It has been seen in this study that good antenatal care is of paramount importance and was associated with higer rate of vaginal delivery is pregnancy with history of one caesarean section. In this series the post Partum hemorrhage was higher in vaginal delivery group and wound infection rate was high in caesarean group. J Bangladesh Coll Phys Surg 2021; 39(1): 36-45

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