title: Evaluation of pregnant women with scarred uterus in a low resource setting.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow (UP), India. corpmate@gmail.com
authors.forename: Anjoo
authors.initials: A
authors.lastname: Agarwal
authors.forename: Poonam
authors.initials: P
authors.lastname: Chowdhary
authors.forename: Vinita
authors.initials: V
authors.lastname: Das
authors.forename: Aarti
authors.initials: A
authors.lastname: Srivastava
authors.forename: Amita
authors.initials: A
authors.lastname: Pandey
authors.forename: Meenakshi T
authors.initials: MT
authors.lastname: Sahu
mesh_terms: 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