Pregnancy outcome in women with previous one cesarean section.
OBJECTIVE
The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section in relation to vaginal delivery and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of scar (TOS).


METHODS
A retrospective analysis of medical records of 151 women with previous one cesarean section who delivered at the Mafraq Hospital, Abu Dhabi between January-August 2011was carried out. Those women with previous classical cesarean section and those with extreme prematurity were excluded. The collected data were analyzed using SPSS software version 20. Continuous and categorical data were presented in the form of mean, standard deviation and percentage, while proportions were analyzed using the chi-square test. A p-value ≤0.05 was considered statistically significant.


RESULTS
Of the 151 women, 115 were candidates for TOS. Of them, 96 (83.47%) had vaginal birth after cesarean (VBAC) and 19 (16.5%) had a repeat cesarean section. There were four cases of primary postpartum hemorrhage (PPH) and two cases of scar dehiscence in the study group. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.


CONCLUSIONS
In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL.
Clinical Associate Professor, Department of Obstetrics and Gynaecology, Amritha institute of Medical Sciences , Kochi, Kerala, India .
Lekshmi
L
Balachandran
Specialist, Department of Obstetrics and Gynaecology, Madinat Zayed Hospital , Abudhabi, UAE .
Pooja R
PR
Vaswani
Consultant, Department of Obstetrics and Gynaecology, Cape Town, South Africa .
Ramakone
R
Mogotlane
Elective Repeat cesarean section; Trial of labour; Trial of scar; VBAC