Review of vaginal birth after primary caesarean section without prostaglandin induction and or syntocinon augmentation in labour.
OBJECTIVE
To show the results of vaginal birth after primary caesarean (VBAC) without using prostaglandin for induction and/or syntocinon augmentation are comparable when induction is done with these agents but without the added risks of uterine rupture.


METHODS
A review of the obstetric records of 16,498 parturient from 1 January 2001 to 31 December 2006 was carried out. The 229 cases of women who wanted VBAC were subjected to further analysis to determine the number of successful vaginal delivery after spontaneous onset of labour or membrane sweep. The instrumental vaginal delivery rate, analgesia commonly used and the complication rate were analysed.


RESULTS
The result showed that 34.49% had spontaneous onset of labour, 27.07% laboured after membrane sweep and 38.42% had repeat urgent caesarean section as they failed to go into spontaneous labour. Of those who went into labour spontaneously or after membrane sweep, 67% had vaginal delivery, a further 13.97% had instrumental vaginal delivery and 16% had emergency caesarean section. There was no case of uterine rupture.


CONCLUSIONS
VBAC can end successfully in a high proportion of cases without the use of prostaglandin or syntocinon for induction of labour and or syntocinon for augmentation in these women because of their associated increased relative risk of uterine rupture.
Ogbonmwan
S E O
SE
Department of Obstetrics & Gynaecology, Calderdale Royal Hospitals Halifax ,West Yorkshire, UK. steveogbonmwan@aol.com
Miller
V
V
Ogbonmwan
D E
DE
Akinsola
A A
AA
D000328:Adult; D016362:Analgesia, Obstetrical; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011453:Prostaglandins / Q000008:administration & dosage*; D012307:Risk Factors; D014597:Uterine Rupture / Q000453:epidemiology / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*
D010120:Oxytocics; D011453:Prostaglandins; D010121:Oxytocin