Study of maternal and fetal outcome in previous caesarean section

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

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Maternal and perinatal outcome of pregnancy in women with one previous caesarean section-a study at a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205246 ◽

2020 ◽

Vol 9 (12) ◽

pp. 5055

Author(s):

Deepthi Venkatesh ◽

Varun G. Huilgol ◽

Gopalkrishna B. Huilgol

Keyword(s):

Caesarean Section ◽

Tertiary Care ◽

Fetal Outcome ◽

Previous Caesarean Section ◽

Tertiary Care Centre ◽

Hospital Department ◽

Mortality And Morbidity ◽

Select Group ◽

History Of ◽

Obstetric Population

Background: Increasing rates of primary caesarean section has led to an increased proportion of obstetric population with history of prior caesarean delivery. There is growing concern by obstetrician for optimizing the management of these high risk cases. The present study was undertaken to evaluate obstetric and fetal outcome of patients presenting at term with history of one previous LSCS.Methods: This was a prospective hospital based observational study conducted at Vani Vilas Hospital and Bowring and Lady Curzon Hospital, Department of OBG, BMC and RI, Bangalore. The study included 300 patients who had undergone previous one LSCS with term pregnancy.Results: Majority of patients, that is 186 (62%) were in the age group of 21 to 25 years. Out of 300 patients, 94 (31.33%) patients went for repeat LSCS without trial. 206 (68.67%) patients were included in the trial of labour group, out of which 109 (52.9%) patients had successful vaginal delivery. 97 (47.1%) patients went for repeat LSCS in trial group due to various indications, commonest being scar tenderness.Conclusions: Delivery of patients with previous caesarean section should always be conducted in a well-equipped hospital where facilities for immediate intervention are available if necessity arises. These patients should be counselled antenatally regarding institutional delivery, encouraging trial of labour after caesarean section in select group of patients with close fetal and maternal monitoring for early detection of complications and its management reduces maternal and perinatal mortality and morbidity.

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Prelabour Uterine Rupture In Two Patients With A Previous Caesarean Section For Placenta Previa

10.21203/rs.3.rs-51863/v1 ◽

2020 ◽

Author(s):

Miriam Dellino ◽

Francesco Maria Crupano ◽

Xuemin He ◽

Antonella Vimercati

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Uterine Rupture ◽

Placenta Previa ◽

Fetal Outcome ◽

Pregnancy Complication ◽

Previous Caesarean Section ◽

Careful Evaluation ◽

Spontaneous Uterine Rupture ◽

History Of

Abstract Background Spontaneous uterine rupture is a severe pregnancy complication. Several risk factors have been described, especially for women with a previous caesarean section.Method We reported two cases of uterine rupture (UR) occurred outside of labour in patients with a history of caesarean section for placenta previa were reports. Results The current study evaluates how a higher hysterotomy, combined with some risk factors, can increase the prevalence of UR in the next pregnancy. Conclusion These cases presentation provide a supplement to over-all knowledge about UR showing that a careful evaluation of risk factors could promote the early UR management and consequently, improve the maternal-fetal outcome.

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STUDY OF OBSTETRIC AND FETAL OUTCOME OF PREGNANCY IN PREVIOUS CAESAREAN SECTION

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1862 ◽

2015 ◽

Vol 4 (74) ◽

pp. 12908-12915

Author(s):

Gurpreet Kaur Nandmer ◽

Anjali Kanhere

Keyword(s):

Caesarean Section ◽

Fetal Outcome ◽

Previous Caesarean Section

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Clinical study of cases of ruptured uterus in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175856 ◽

2017 ◽

Vol 7 (1) ◽

pp. 253

Author(s):

Anubha Vidyarthi ◽

Santwana Kumari

Keyword(s):

Risk Factor ◽

Caesarean Section ◽

Skilled Birth Attendant ◽

Fetal Outcome ◽

Previous Caesarean Section ◽

Mortality And Morbidity ◽

Risk Factor Management ◽

Incidence Risk ◽

One Year ◽

Ruptured Uterus

Background: Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal morbidity and mortality. It is a preventable condition. Timely diagnosis and management results in better outcome. The objective of this study was to determine incidence, risk factor, management, maternal and fetal outcome in cases of uterine rupture.Methods: A retrospective study of cases of ruptured uterus was done over a period of one year from January 2015 to December 2015. The case sheets of patients were traced through labor room register, operation theatre register and medical record section.Results: There were 57 cases of ruptured uterus out of total 8112 deliveries in labor room, giving incidence of 7.03/1000 deliveries (0.7%). The most common risk factor was previous caesarean section in 59.7% of cases. In 54.4% cases patients were multiparous (≥3). Most of the patients presented with poor general condition, abdominal pain and tenderness, palpable fetal parts and in shock in 68.4% cases. Patients were treated with immediate resuscitation and laparotomy followed by either repair or hysterectomy. There was high perinatal mortality of 89.5%. Maternal mortality was 3.5%.Conclusions: Proper antenatal care, appropriate counselling of patients with history of previous caesarean section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity associated with rupture uterus.

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