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.

CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Birth ◽  
Fetal Macrosomia ◽  
Major Influence ◽  
Maternal Complications ◽  
Perineal Tear ◽  
History Of

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.

scholarly journals Assessing the pros and cons of vaginal birth after caesarean relative to elective repeat caesarean section

2020 ◽  
Vol 9 (4) ◽  
pp. 1350
Author(s):  
Sangeeta G. Prasad ◽  
Preeti Malhotra
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
Maternal Complications ◽  
Neonatal Complications ◽  
Trial Of Labor ◽  
Significant Difference ◽  
Vaginal Birth After Caesarean

Background: Recent years have witnessed a rise in rate of primary caesarean section (CS). No. of women reporting with a previous CS scar is also increasing. Judicious trial of labor in such patients can prevent repeat caesarean section. Aim of this study was to assessing the safety and success rate of vaginal birth after caesarean (VBAC) in selected cases of patients who have undergone previous lower segment CS (LSCS) is the main aim of this study.Methods: In this prospective observational study carried out in a tertiary care teaching hospital over a period of 1 year. 375 pregnant women with a history of one previous LSCS for non-recurrent indications were enrolled. The statistical technique of t-test was administered for relative comparison with respect to maternal and neonatal complications across the two groups, i.e. repeat LSCS and vaginal delivery.Results: Out of 375 patients 187 patients (49.9%) underwent elective LSCS for recurrent indication and for non-recurrent indication associated with some complicating factor. Trial of labor in 188 (50.10%) was given out of which 59.3% had spontaneous vaginal delivery,7.20% had instrumental delivery and 33.50% landed into emergency CS. Commonest cause of Em. LSCS being Fetal distress. As regards maternal complications, no statistically significant difference was found between the Repeat LSCS and Vaginal delivery groups (t = 0.779, p > 0.05). On similar lines, there was no statistically significant difference across both groups as regards neonatal complications (t = 0.632, p > 0.05).Conclusions: Taking into account the increased trend of primary CS, trial of VBAC in selected cases is very important. It can be concluded that VBAC has chances of success in cases with previous one LSCS but it must be carefully investigated and monitored.

scholarly journals VAGINAL BIRTH AFTER CAESAREAN SECTION

2010 ◽  
Vol 17 (04) ◽  
pp. 665-669
Author(s):  
SUNBAL KASHIF ◽  
MALAHAT MANSOOR ◽  
RUBINA TARIQ ◽  
Tayyaba Tahira
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
Bishop Score ◽  
Cross Sectional ◽  
Vaginal Birth After Caesarean

Introduction: Vaginal birth after caesarean section is currently the preferred method of delivery for pregnant women who had previous one lower segment caesarean section. This common practice warrants some reconsideration in light of recent clinical data on the risks associated with VBAC. Objectives: To evaluate conditions which can achieve successful vaginal birth after one caesarean section. Study Design: Cross-sectional analytic study. Setting: Department of Obstetrics and Gynaecology, Unit-I, Services Hospital, Lahore. Duration of Study with Dates: Study was carried out over a period of six months from 08-06-2006 to 07-12-2006. Subjects and Methods: One hundred pregnant women meeting inclusion criteria were included. During trial of labour patients were closely monitored by vital signs, fetal cardiac activity, lower abdominal pain and tenderness, fetal distress, vaginal bleeding and loss of presenting part. Results: Mean age of the patients was 34.27 + 6.45. According to distribution of cases by parity, maximum number i.e 64 (64.0%) was P 3-6. 79 patients (79.0%) had prior vaginal delivery. Maximum 41.0% patients were due to fetal distress while in 28% indication for previous caesarean were breech presentation. In 71% patient membranes were intact while 29.0% patients presented with per vaginal leaking. 51.0% had dilatation between 3-4cm. VBAC was more successful in patients 58.0% with favourable Bishop score. Conclusions: BMI <20, prior vaginal delivery, non-recurrent indication for previous caesarean, spontaneous onset of labour, cervical dilatation or favourable Bishop score, weight of baby < 3.5kg predict an individual’s likelihood of successful VBAC.

scholarly journals Maternal and neonatal outcome in pregnancy with previous lower segment caesarean section undergoing trial of scar

2021 ◽  
Vol 10 (9) ◽  
pp. 3434
Author(s):  
Monika Dalal ◽  
Smiti Nanda ◽  
Jagjit S. Dalal ◽  
Samiksha Kaushik ◽  
Meenakshi Chauhan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Emergency Caesarean ◽  
Vaginal Birth After Caesarean

Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.

scholarly journals Outcome of Women with Previous Cesaerian Section At A Tertiary Care Hospital in Eastern Nepal

2015 ◽  
Vol 12 (1) ◽  
pp. 18-23
Author(s):  
Ajay Agrawal ◽  
S Chhetri ◽  
A Thakur ◽  
S Agrawal ◽  
P Basnet
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Previous Caesarean Section ◽  
Vaginal Birth After Caesarean

Background: Pregnant women with previous caesarean section are increasing due to the liberal use of caesarean section in first pregnancy due to multifactorial reason. The risks, benefits, and relative safety of vaginal birth after caesarean (VBAC) have been subject of interest for well over 100 years. Thus mutual understanding between the treating obstetrician and patient herself is a core towards achieving good maternal and perinatal outcome considering all the risk and benefit in women with previous caesarean section. Objective: The aim was to analyze the maternal and perinatal outcome in pregnant women with previous caesarean section. Methods: In this prospective observational study, 300 women with singleton pregnancy in cephalic presentation with previous one lower segment caesarean section (LSCS) having inter pregnancy interval ≥ 18 months presenting at ≥ 37-41 week period of gestation admitted for delivery were enrolled and various maternal and perinatal outcome were noted. Results: Caesarean delivery rate during the study period was 26.95%. Eighty percent of eligible women opted for trial of labor. Successful vaginal birth after caesarean section was 29%. Elective repeat caesarean delivery was 19.66%. The rate of failed VBAC was 51%. Failed VBAC increased with increasing weight of baby. There was no difference in mean birth weight among patient who had successful VBAC, who refused VBAC and who had failed VBAC. Mode of delivery had no significant effect on the number of neonatal intensive care unit admission and number of still births.  DOI: http://dx.doi.org/10.3126/hren.v12i1.11980Health Renaissance 2014;12(1):18-23

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

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

Vaginal birth after Caesarean section: what information should women be given?

Clinical Risk ◽  
2007 ◽  
Vol 13 (4) ◽  
pp. 127-130 ◽  
Author(s):  
Leroy Edozien
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Unmet Need ◽  
Informed Choice ◽  
Subsequent Pregnancy ◽  
Vaginal Birth ◽  
Sufficient Information ◽  
Evidence Based ◽  
Random Allocation ◽  
Vaginal Birth After Caesarean

With rising Caesarean section (CS) rates, more women are having to consider the choice between an elective CS and a vaginal delivery (VBAC) in their subsequent pregnancy. This paper argues that there is an unmet need for clinicians to provide sufficient information to women in this position, so that the woman's choice can be an informed one. Consent should be evidence-based, but there are currently no published random-allocation studies comparing VBAC with elective repeat CS. However the available evidence could be better used by clinicians to facilitate informed choice.

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