scholarly journals Analysis of success of vaginal birth after cesarean in relation to indication of primary caesarean section: a tertiary care experience

2019 ◽  
Vol 8 (11) ◽  
pp. 4440
Author(s):  
Neha Gupta ◽  
Arpita De ◽  
Nidhi Gupta
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
Successful Outcome ◽  
Vaginal Birth After Cesarean ◽  
Previous Pregnancy ◽  
Care Experience ◽  
Failed Induction ◽  
Vaginal Birth After Caesarean

Background: Apprehensions related to vaginal birth after caesarean (VBAC) has reduced rates of successful vaginal trials over last decade. The objective of this study was to identify the indications of first caesarean section that can lead to a successful trial of labour in subsequent pregnancy.Methods: Retrospective cohort study was done between November 2014 and October 2017. Data from the case records was analysed.Results: Study over 3 years from 2014 to 2017 revealed fetal distress (82.7%),  breech (72.2%), transverse lie (66.7%), antepartum haemorrhage (56.2%) and twins with first non-cephalic (57.9%) have successful outcome of VBAC whereas obstructed labour (19.2%) and failed induction (18.4%) in previous pregnancy have poor outcome for VBAC.Conclusions: Attempts to allow trial of labour after one previous caesarean section with fetal distress, malpresentation and twins as indications of caesarean in previous pregnancy are safe and should be encouraged.

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 The Outcome of Vaginal Birth After Caesarean Section (VBAC): A Descriptive Study

2013 ◽  
Vol 25 (1) ◽  
pp. 14-17
Author(s):  
R Rahman ◽  
NN Khanam ◽  
N Islam ◽  
KF Begum ◽  
HH Pervin ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Lower Segment Cesarean Section ◽  
Medicine Today ◽  
Vaginal Birth After Caesarean

The study, conducted in the tertiary care hospital of Dhaka Bangladesh, describes the outcome of vaginal birth after caesarean section (VBAC) in women with a previous caesarean. A prospective study was carried out from 1st January 2007 to 31st December, 2007 on 126 women with one prior lower segment cesarean section (LSCS) for a nonrecurrent cause. All unbooked women and those with estimated fetal weight more than 3.5 kg, breech presentation, history of postoperative wound infection after previous LSCS, anemia (Hb < 10 gm%), pregnancy induced hypertension, diabetes, heart disease, renal disease, cephalopevic disproportion abnormal presentation and placenta praevia were excluded from the study. An informed consent was taken for allowing a trial of vaginal delivery. Spontaneous onset of labor was awaited up to 41 weeks. Induction of labor was considered only in highly selected cases. Labor was constantly supervised by competent staff and meticulously monitored by cardiotocography (CTG). Out of the 126 women enrolled for the study, 26 had to leave the station leaving a total of 100 patients; 72 patients underwent elective repeat C/S, 28 patients (28%) of these underwent trial of labour, among them 15 had successful vaginal delivery (53.57) but 13 patients failed the attempt and had to undergo emergency caesarean section. To assist in the 2nd stage of labour, 6 had ventouse application. In total 85 cases needed repeat caesarean section. Among the cases there was one case of scar dehiscence (6.6%), one case of cervical tear (6.6%), two cases of manual removal of placenta (13.3%), one case of post partum hemorrhage (6.6) and one case of puerperal pyrexia (6.6).Perinatal morbidity was comparable with the elective repeat C/S group. VBAC should be considered in cases of previous one cesarean delivery for nonrecurrent indication. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15902 Medicine Today 2013 Vol.25(1): 14-17

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 Trial of Vaginal Birth After Caesarean (VBAC): Sharing Experience From a Tertiary Care Center of Eastern Nepal

2018 ◽  
Vol 7 (1) ◽  
pp. 18-25
Author(s):  
Sita Pokhrel Ghimire ◽  
Ashima Ghimire ◽  
Aruna Pokharel ◽  
Sabina Lamichhane ◽  
Mahanand Kumar
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Tertiary Care ◽  
College Teaching ◽  
Vaginal Birth ◽  
Attractive Alternative ◽  
Medical College ◽  
Trial Of Labor ◽  
Previous Cesarean ◽  
Vaginal Birth After Caesarean

Background: Rising rates of cesarean section is a matter of great concern and trial of labor in previous cesarean section women is an attractive alternative. Vaginal Birth After Caesarean (VBAC) may be one of the strategy developed to control the rising rate of cesarean deliveries in our country. Analyzing outcome of previous caesarean pregnancies will provide an insight for reducing the caesarean rates and formulating protocols and policies for trial of labor. The purpose of this study is to evaluate the pregnancy outcome in previous caesarean section women with VBAC trial with the hope of avoiding unnecessary repeat caesarean section rates. Methodology: It is a cross-sectional observational institute based study carried out in Nobel Medical College Teaching Hospital from 15th March 2017 to 14th March 2018 after the approval from Institutional Review Committee (IRC). This consists of patient with past history of cesarean section, who delivered in NMCTH during the study period and meeting the Royal College of Obstetrics and Gynecology (RCOG) inclusion criteria for VBAC. Feto-maternal outcomes were analysed. Results: There were 1225 previous cesarean cases, among them, we did VBAC trial in 135(11%) patients, 99 (73.33%) had successful vaginal delivery whereas 36(26.66%) could not do the same after labor trial. Feto-maternal outcome was better in VBAC patients than cesarean group.No maternal and neonatal mortality occurred. Conclusion: In the country like ours where rate of caesarean section is increasing alarmingly we have to try VBAC in appropriate group of patients. National policy and guidelines are necessary after large multicenter prospective studies. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 18-25

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

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