Evaluation of pregnant women with scarred uterus in a low resource setting.
OBJECTIVE
Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided.


METHODS
An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted.


RESULTS
A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively).


CONCLUSIONS
Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple.
Agarwal
Anjoo
A
Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow (UP), India. corpmate@gmail.com
Chowdhary
Poonam
P
Das
Vinita
V
Srivastava
Aarti
A
Pandey
Amita
A
Sahu
Meenakshi T
MT
D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean