Outcome of a Post Caesarean Pregnancy in a Tertiary Center of a Developing Country 2005-2009
Correspondence
B. Poornima Ramachandra Bhat,
Assistant Professor, Dept of
Obstetrics and Gynecology,Father
Muller Medical College, Kankanady,
Mangalore - 575 002, Karnataka, (India)Fax: 0824-2437402Email:
bprbhat@rediffmail.com,Tel no.:+91
94489 53435
Background: An expectant attitude and individualization with respect to the management of pregnancy and labour in patients who had one caesarean section is not only justifiable, but represents sound and conservative obstetrical practice.
Aims:
1. To study the success rate of vaginal birth after caesarean delivery
2. To know the commonest indication for elective and emergency caesarean section
Methods: A total of 219 cases with a history of previous caesarean section beyond 28 weeks of gestation were included in the study. The collected data was analyzed by chi-square test.
Results:The incidence of post caesarean pregnancy cases were 219(8.76%). Out of these, 113 (51.6%) were selected for trial of labour and 106(48.4%) underwent elective repeat caesarean section. Of the 113 women who were allowed for a trial of labour, 73(64.6%) delivered vaginally and 40(35.4%) delivered by emergency repeat caesarean section. Thus, the success rate of VBAC was 64.6%. So a total of 146(66.7%) women underwent repeat caesarean section and 73(33.3%) delivered vaginally. Cephalopelvic disproportion was the most common indication for elective repeat caesarean section and foetal distress for emergency caesarean section.
Conclusion: VBAC should be considered in cases of previous one caesarean delivery for non recurrent indications.