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 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 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 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 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.

scholarly journals Trial of labor after previous cesarean delivery (TOLAC) and association of BMI and previous vaginal delivery with frequency of VBAC

2016 ◽  
Vol 15 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Huma Tasleem ◽  
Haider Ghazanfar
Keyword(s):  
Cesarean Section ◽  
Success Rate ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Health Centre ◽  
Tertiary Care ◽  
Vaginal Birth ◽  
Trial Of Labor ◽  
Emergency Cesarean ◽  
Previous Cesarean

Objectives: To determine the frequency of successful Vaginal Birth after One Cesarean Section in our tertiary care institution and to determine the causes of its failure.Material and Methods: This study was conducted in department of Obstetrics and Gynecology of Shifa International Hospital and Shifa Foundation Community Health Centre Islamabad Pakistan from Feb 2011 to Dec 2014. This study included 592 patients who presented in labor room emergency reception of Obs/Gynae department at term with previous one scar having fulfilled the laid down inclusion criteria for VBAC during ante-natal care. The patients were admitted in hospital and were allowed to proceed for spontaneous labor under vigilant monitoring on complications of trial of scar. Immediate emergency cesarean sections were performed, where indicated.Results: Out of 592 patients 70.7% were delivered vaginally after previous one cesarean section and 29.3% had emergency cesarean section. Leading indications for repeat cesarean section was fetal distress, failure to progress and scar tenderness. No maternal and fetal complication occurred in our study. The success rate of Trial of labor after one previous cesarean delivery was lower in obese (64.38%) as compared to non-obese women (82.06%) (p<0.001). Women with previous successful vaginal delivery had a success rate of 88.2% compared with 62.25% in women without such a history (OR 4.4; 95% CI 2.7-7.2 p <0.001).Conclusion: Vaginal birth after one lower segment cesarean section should be encouraged with vigilant monitoring provided no obstetric contra-indication to vaginal birth exists.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.546-550

scholarly journals A comparative study of perinatal outcome in primary caesarean in multiparous women to that in nulliparous women

2020 ◽  
Vol 9 (8) ◽  
pp. 3265
Author(s):  
Surabhi Kokate ◽  
Abhishek Kokate
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Primiparous Women

Background: To compare indication, incidence, complication, fetal and maternal morbidity and mortality in primary caesarean section in multiparous women and nulliparous women. Objective of this study was to compare perinatal outcome of caesarean section in multiparous women to that in nulliparous women.Methods: It is a prospective observational study conducted in a tertiary care centre during April 2017 to April 2018. All patients who delivered vaginally and abdominally were noted during study period. All patients undergoing primary caesarean section were noted. Their indication, incidence and complication throughout stay were noted. Statistics were calculated separately for multiparous women and primiparous women. Statistical analysis was done using chi square test.Results: Total 150 primary caesarean section in primiparous women and 100 primary caesarean section in multiparous women were done.  Fetal distress and meconium stained amniotic fluid forms the most common indication in study. Birth weight of babies was more in multiparous women. Need of blood and blood products was more in multiparous women compared to nulliparous women. Complications like postpartum fever and wound gape was more in multiparous women.Conclusions: In the study population significant difference was seen between the indication and complication between multiparous and nulliparous women.

scholarly journals VAGINAL BIRTH AFTER CAESAREAN SECTION;

2013 ◽  
Vol 20 (05) ◽  
pp. 759-764
Author(s):  
SANA ZAHIRUDDIN ◽  
SUMERA RAUF QURESHI ◽  
UMER FAROOQ
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
University Hospital ◽  
Cross Sectional ◽  
Study Results ◽  
Previous Cesarean ◽  
Vaginal Birth After Caesarean

Background: Cesarean section is the commonest obstetrical procedure, associated with increase in maternal morbidity,the cesarean section rate is steadily on the rise in our country which can give rise to a number of complications. Objective: To determinethe factors associated with successful vaginal delivery after previous cesarean section. Study Design: Cross sectional study. Period:May 2009 to October 2009. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilledthe selection criteria were included in the study. Results: The women included in the study had a mean age of+SD(range),29.94+4.41successful vaginal birth was observed in 57(59.5%) women and 39(40.6%) had an emergency repeat cesareandelivery. The factors favoring successful vaginal delivery were history of previous vaginal delivery and previous cesarean due to fetaldistress or breech presentation, and patients having cesarean due to non progress of labor and no prior vaginal delivery were less likely tohave a successful vaginal birth after having previous cesarean delivery. Conclusions: vaginal birth after caesarean section can berecommended in patients having prior vaginal delivery and previous caesarean due to fetal distress and breech presentation.

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