Outcome of trial of Labour after Previous one Caesarian Section

Parveen Naveed, Saima Parveen

Abstract


Background: All over the world, the concern about the increasing rate of caesarean delivery has focused on trial of labour after caesarean section (TOLAC) or Vaginal Birth after Caesarean (VBAC). An important consideration while contemplating trial of labour after caesarean is the risk of uterine rupture. Because of concerns about this complication, the rate of attempted TOLAC continues to fall all over the world.
Objective: To study the outcome of trial of labour in patients with previous one cesarean section.

Material & Methods: It was a prospective observational study conducted from 1 June 2017 to 31 December 2017, in OBS &
Gynea unit of Saidu Teaching Hospital, Swat. All pregnant women of more than 37 weeks gestation, with one previous caesarean section were screened for eligibility criteria for trial of labour. The data obtained were analyzed according to mode and outcome of labour and was then subjected to statistical analysis on SPSS version 20.
Results: A total of 281 deliveries were carried out. Out of the 281 women, 63.90% (n-80) had normal delivery, 35.50% (n-47) underwent emergency c/section while 154 had ELCS done and were excluded from the study, thus making a success rate of 63% for TOLAC for the study population.
Conclusion: TOLAC should be considered in women in low resource setting after thorough assessment and proper counseling of patient. Good patient selection and appropriate one to one surveillance are important steps of successful TOLAC.


Keywords


Vaginal birth after cesarean section, Trial of labour after cesarean section

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