To Determine the Mode of Delivery after Previous Caesarean Section Either VBAC or ERCS

Abstract

Background & Methods: The aim of the study is to determine the mode of delivery after previous caesarean section either VBAC or ERCS. All pregnant women with previous caesarean section coming to the department was taken up for study after written and informed consent. Detailed history of patients with previous caesarean section attending antenatal clinic including a detailed obstetric history with special reference to indication of previous caesarean, preoperative, intra operative and postoperative complications, wound sepsis and delayed stitch removal was taken into account. Results: The presence of prior vaginal delivery after caesarean section was associated with increased success of VBAC as seen in this study. Out of 112, 64 cases (57.14%) had prior one vaginal delivery and underwent successful VBAC in the present pregnancy. In the other group of emergency repeat caesarean section, 75.51% cases had no previous history of vaginal delivery. The above stated results were statistically significant. Conclusion: In the present study number of booked cases were 53.84% and unbooked were 46.15%. Rate of vaginal delivery was more in booked cases i.e. 74.10% than in unbooked cases 25.89%. Substantial reduction in the caesarean rates can be achieved safely and efficiently by encouraging the trial of labor in women with a single previous LSCS. Successful trial of labor in previous caesarean section is associated with better maternal and perinatal outcomes. We further proved that in the cases of non recurrent causes of previous LSCS, a fair trial of labor can be given. Caesarean section should not be always followed by repeat caesarean section but patients must have regular ANC visits and have hospital delivery in well equipped hospital and complications should be diagnosed at an early stage so that we can prevent maternal and perinatal morbidity and mortality.

Keywords: delivery, caesarean, VBAC and ERCS.