Background:Acomprehensive study of maternal morbidity and mortality with perinatal outcome in patients with prior LSCS undergoing elective
or emergency caesarean section was carried out. With the sky rocketing caesarean section rates worldwide an increasing number of women face the
issue of mode of delivery in their current pregnancy. There are conicting reports regarding the safety of a trial for vaginal birth after caesarean
delivery (VBAC) in terms of uterine rupture, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal
outcomes of patients presenting at term with a history of previous one or more LSCS.
Methods:Asix months prospective, observational study was conducted where all patients who had a term pregnancy with a history of previous one
or more LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients with elective or
emergency LSCS in the present pregnancy were noted and tabulated. Adescriptive analysis of these outcomes was carried out.
Results: 100 Patients at term, with a history of previous one or more LSCS were studied. 38 patients underwent an elective repeat caesarean
delivery and 62 in emergency.Scar dehiscence was seen in 35.5 % of the patients who were presented in emergency with uterine contractions or
lower abdominal pain and those were not candidate for a trial for VBAC.All of the complications were signicantly higher in emergency group in
terms of both maternal (83.9 % Vs 31.6%) and perinatal outcome (6.5% Vs 0 %).
Conclusion:With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper
antenatal counseling regarding plan of delivery and vigilance while operating patients with prior history of LSCS , especially in emergency
situation.
There should be a well dened management protocol in an effort to decrease the number of complications and bring down the overall maternal
morbidity & mortality .
