Vaginal Birth After Trial of Uterine Scar | [Journal of Surgery Pakistan • 2019]

Author(s):

1. Farrukh Naheed: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

2. Nikhat Ahsan: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

3. Aisha Qayyum: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

4. Farah Liaquat: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

5. Saadia Akram: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

6. Farheen Sheikh: Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, Pakistan

Abstract:

Objective To determine the frequency of vaginal birth after trial of uterine scar and its associated maternal and perinatal complications. Study design Cross-sectional study. Place & Duration of study Department of Obstetrics and Gynaecology, Baqai Medical University Karachi, from January 2016 to December 2018. Methodology All admitted patients, booked or unbooked, with previous one cesarean section after 28 weeks were included in this study for the trial of labour after cesarean section (TOLAC). Demographic features like age, parity, gestational age, previous history of vaginal birth after cesarean section (VBAC) and previous history of assisted vaginal deliveries were recorded. Patients with previous one cesarean section, associated medical disorders and obstetric complications in previous pregnancies were excluded. Patients with BMI > 30 kg/m2 and expected fetal weight (EFW) =3.5 kg were also excluded. Data was analyzed through SPSS version 22. In 135 (64.9%) women successful VBAC occurred while 73 ( 35.1%) had emergency cesarean section after TOLAC. 165 (79.3%) women belonged to age group <35 years. Multigravidas had lower success rate for TOLAC (n= 98 - 47.1%) as compared to (n=120 - 57%) women with low parity. Majority of women (n= 192 - 92.30%) were at term selected for TOLAC with the duration of >2 years since last delivery. There were 6 (3.4%) perinatal mortalities in this study. Only 2 (1.4%) patients had postpartum haemorrhage due to scar d e h i s c e n c e a n d p l a c e n t a a c c r e t a w h i c h w a s a n i n c i d e n t a l d i a g n o s i s . Conclusions Despite the known complications of pregnancies with previous scar to be delivered vaginally TOLAC was appropriate for many pregnant women at term, leading to a successful outcome in high proportion of cases.

Page(s): 131-135

DOI: DOI not available

Published: Journal: Journal of Surgery Pakistan, Volume: 24, Issue: 3, Year: 2019

Keywords:

Elective repeat , Perinatal and maternal mortality , Trial of labour after cesarean section

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