Abstract
Objectives: Our study was to evaluate the mode of delivery, operative difficulties of post caesarean section pregnancy, Frequency of postpartum complication, foetal and maternal morbidity and mortality in post caesarean section pregnancy, and Indication of subsequent caesarean section, Clinical condition of previous caesarean section scar and placenta and evaluate the foetal outcome between abdominal and vaginal deliveries.
Methodology: A total of 150 women cases with age group ≥20 years to 40 years of post caesarean section were included in this study. A detail relevant history, assessment, investigation were taken to all cases of post caesarean section. Elective caesarean section was done in cases where there was contraindication of allowing labour and vaginal delivery. Condition of baby was assessed by apgar score at 1 min. and 5 minutes. Special emphasis was given on the weight of the baby in respect to the mode of delivery and complication occurring during labour and delivery. During the first 7 days the baby was observed closely for well being.
Results: Data was analyzed by using simple statistical methods with the help of MS-Office software.
Conclusions: VBAC was better chance for successful in pregnancy. Recurrent and non recurrent cause of primary caesarean section changes the outcome. Due to lesser number of maternal and perinatal mortality, vaginal deliveries have a much safer outcome than repeat sections. The major cause of perinatal mortality in repeat caesarean was prematurity. To avoid this cause of perinatal mortality, we can wait for each and every patient having previous caesarean section for spontaneous labour keeping everything ready for caesarean section.
Keywords: post caesarean section, vaginal delivery, outcomes.
References
- Curtin SC. Rates of caesarean birth and VBAC, 1991-95. Monthly vital statistics report ; 45(11) Suppl 3 Hyattsville (MD) : National center for Health statistics; 1997.
- Rates of caesarean delivery – United States, 1991 – MMWR Morb Mortal Wkly Rep 1993 ; 42 : 285-9.
- Stafford RS. Alternative strategies for controlling rising caesarean section rates. JAMA 1990; 263 : 683-7.
- Cragin EB. Conservatism in obstetrics. NY Med J 1916; 104(1): 1-3.
- Enkin, M.J.N.C. Keirse, J. Nielson, C. Crowther, L. Duley, E. Hodnett, and J. Hofmeyr. A Guide to Effective Care in Pregnancy and Childbirth. Oxford University Press, 2000. 7. M. Enkin, M.J.N.C. Keirse, J. Nielson, C. Crowther, L. Duley, E. Hodnett, and J. Hofmeyr. A Guide to Effective Care in Pregnancy and Childbirth. Oxford University Press, 2000.
- Rosen M.G., Dickinson J.C, and Westhoff C.L. (1991). Vaginal birth after caesarean: a meta-analysis of morbidity and mortality. Obstet. Gynecol., 1991; 77, 465-70.
- Pickhardt M, Martin J, Meydrech E, Blake P, Martin R, Perry K. Vaginal Birth after caesarean delivery : Are there useful and valid predictors of success or failure. Am J Obstet Gynaecol 1992 ; 166 : 1811.
- Chattopadhyay K, Sengupta B, Edress Y, Lambourne A. Vaginal Birth After caesarean section : Management Debate. Am J Obstet Gynaecol 1988 ; 26 : 189.
- Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal & Perinatal outcomes associated with a trial of labour after prior caesarean delivery. N Engl J Med 2004; 351:2581 - 2589.
- Gonen R, Nisenblat V, Barak S, Tamir A, Ohel G. Results of a well defined protocol for a trial of labour after prior caesarean section. Obstet Gynecol 2006; 107:240-5.
- Allahabadia N, Ambiye V, Shanbaug. Vaginal birth following caesarean sections. J Obstet Gynaecol India 1989 ; 39 : 782.
- McGarry J. The management of patients previously delivered by caesarean section. J Obstet Gynaecol Brit 1969 ; 76 : 137.
- Graham A. Trial of labour following previous caesarean section. Am J Obstet Gynecol 1984 ; 149 : 35.
Corresponding Author
Dr Kumari Khushboo
Post Graduate Trainee, Dept of Obstetrics & Gynaecology, Katihar Medical College, Katihar, Bihar, India
Ph: +91 8757510941, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.206
