scholarly journals Comparative study of maternal and fetal outcome in patients with Vaginal Birth after caesarean section and elective repeat caesarean section

2020 ◽  
Vol 11 (4) ◽  
pp. 5473-5480
Author(s):  
Poonam Kalburgi ◽  
Sanjaykumar Patil

Women after delivering her first baby by section have a choice about mode of delivery for her second baby. The study was planned to compare maternal and perinatal outcome between VBAC and repeat elective LSCS in patients with prior one LSCS and their complications. A prospective observational study was carried out in department of obstetrics and . Total 180 cases of previous LSCS who were eligible for vaginal delivery were recruited 90 in each group as per consent given by them. Group 1: Vaginal Birth after section Group 2: elective repeat section. It was observed that majority of the patients group 1(51.1%) and group 2 (47.8%) were in age group of 25 to 30 years. More than 25kg/m2 BMI was found in 18(20%) cases of VBAC group and 30(33.3%) cases of LSCS group pregnancy interval was significantly lower in LSCS group compared to VBAC group. Mean birth weight was 2.832 kg to 2.917kg in both group. with improved maternal care, close fetal monitoring and institutional delivery for a previous one section, VBAC is considered safer than repeat elective section in carefully selected patient.

2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.


2020 ◽  
Vol 17 (4) ◽  
pp. 491-494 ◽  
Author(s):  
Rekha Poudel ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  

Background: Aims of this study was to assess the caesarean section rate and identify the indications contributing to the same using the Robson’s Ten Group Classification System at Kathmandu Model Hospital.Methods: This was a retrospective study conducted at Kathmandu Model Hospital among women who underwent caesarean section from 1 January to 31 December, 2018 and were grouped according to Ten Group Classification System. The overall caesarean section rate and the contribution of each group was calculated.Results: The overall caesarean section rate was 66.1% (494 among 747 total deliveries) in 2018. Nullipara, singleton cephalic, >= 37 weeks, spontaneous labor (Group 1) was the major (24.2%) contributor to the overall caesarean section rate followed by previous caesarean section, singleton cephalic, >=37 weeks (Group 5, 22.6%) and nullipara, singleton cephalic, >=37 weeks, induced or caesarean section before labor (Group 2, 18.8%). Also, the caesarean section rate was 49.5% in nullipara, thus increasing the trend of caesarean section for previous caesarean section in future.Conclusions: Efforts must be focused more on Group 1, 2 and 5 to decrease the increasing trend of caesarean section Promoting vaginal delivery in nullipara and facilitating vaginal birth after caesarean are the most relevant areas of intervention. Keywords: Caesarean section; Robson ten group classification system; vaginal birth after caesarean.


Author(s):  
Soad Ajroud ◽  
Raga A. Elzahaf ◽  
Fawzia A. G. Arhaiam

Background: Vaginal birth after caesarean section is one strategy that has been developed to decrease the rate of caesarean section.Methods: The prospective observational study was carried out over a period of 01 January 2017 to 31 December 2018 years. VBAC was routinely offered at Al-Wahda hospital Derna to women fulfilling the criteria for trial of scar, according to the hospital protocol.Results: A total of 5018 deliveries took place in the study duration, there were 1039 (20.7%) had previous one caesarean section, out of which 319 (30.7%) were the number of underwent repeat caesarean section and 720 (69.3%) were the number of VBAC. The indications for emergency repeat caesarean section at Al-Wahda hospital was (29.3%) malpresentation, (24.45%) FD, (13.47) postdate, (11.59) obstracted lab and abruptiopl (5.95%). Anemia and difficult intubation were observed in repeated caesarean section.Conclusions: This study concluded that there is a high chance of success in a trial of labor. These findings might help clinicians and women in the decision-making for the mode of delivery when it comes to pregnancy with a previous caesarean section. Women are explained about the option of trial of scar and told about the risk associated with a repeat CS, so many CSs can be avoided.  


2017 ◽  
Vol 2 (2) ◽  
pp. 36-44
Author(s):  
Chro N. Fattah ◽  
Hazha Jalal

The proportion of women who attempt vaginal birth after prior cesarean delivery has   decreased mainly because of the concern about safety.  The purpose of this study is to observe maternal & neonatal outcomes in women delivered either by vaginal birth after caesarean section, elective repeat caesarean section or failed trial of labour. To design a definite protocol for selection of patient to achieve successful vaginal birth after caesarean (VBAC) section. A prospective observational study was set at Sulaimani Maternity Teaching Hospital/ Kurdistan region of Iraq, from first July 2013 to first July 2014. In which 200 pregnant women (with one prior caesarean section & singleton, term, cephalic presentation) were enrolled, followed up during labour & puerperium for maternal & neonatal complications.  Data analysis was performed using the statistical software namely (SPSS   version 20). Planned vaginal birth was successful in 63.4% of pregnant women, with the least maternal and neonatal complication, apart from 3rd degree perineal tear (2.3%) which was statistically significant (probability value < 0.001). In conclusion, the women who had successful vaginal birth after caesarean, had better result for the mother and neonate than failed trial of labour and those who had elective repeat caesarean section. Women with body mass index of < 30kg/m2, age <30 years, inter pregnancy interval >18months, non-recurrent cause of previous scar and estimated fetal weight of < 4kg, had more successful VBAC rate.


2013 ◽  
Vol 11 (1) ◽  
pp. 38-42 ◽  
Author(s):  
P Dahal ◽  
B Banerjee ◽  
DK Uprety ◽  
BP Das ◽  
A Thakur ◽  
...  

Background: Labour is the most perilous journey a woman has to undertake. Painless and short labour is desired by every woman and is a constant aim for obstetrician.Objective: To analyze and compare the efficacy and safety of drotaverine and valethamate with control group on improving cervical dilatation and promoting progress of labour. Method: Three hundred demographically similar women, both primigravida and multigravida with a term pregnancy in established labour were randomly divided into three groups. One hundred women (group 1) were given injection valethamate intramuscularly,100 women (group 2) were given drotaverine and the rest 100 (group 3) were not given any drug. Comparative analysis was carried out as regards to duration of first stage of labour, mode of delivery, maternal side effects and fetal outcome. Results: The mean duration of active phase of labour in group 1, 2 and 3 was 254.29±96.621 min, 178.31±73.412 min and 346.31±123.351 min respectively. The duration of injection to end of first stage of labour in valethamate and Drotaverine group was 228.12±84.626min and 168.89±69.576min respectively (p value<0.0001). The duration of injection to delivery in Valethamate was 249.13± 88.321 min and in Drotaverine was 192.56±75.479min (p value<0.0001). There were no serious maternal and fetal adverse effects in any group but minor side effects were more common in valethamate group. Conclusion: The reduction of the duration of the first stage of labour was apparently more in drotaverine group as compared to valethamate and control group. Drotaverine was found to be safe with minimal or no adverse effect on the mother and the fetus. Health Renaissance, January-April 2013; Vol. 11 No.1; 38-42 DOI: http://dx.doi.org/10.3126/hren.v11i1.7600


2011 ◽  
Vol 4 (4) ◽  
pp. 164-165 ◽  
Author(s):  
Hemant Maraj ◽  
Michelle Mohajer ◽  
Deepannita Bhattacharjee

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.


Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit Gavhane ◽  
Vishesha Yadav ◽  
Kunal Aher ◽  
Dhruval Bhavsar

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.


Author(s):  
Shreedevi Kori ◽  
Dayanand Biradar ◽  
Aruna Biradar ◽  
Rajasri Yaliwal ◽  
Subhashchandra R. Mudanur ◽  
...  

Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.


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