Study of Maternal and Perinatal Outcomes associated with a Trial of Labor after Previous Cesarean Delivery

Author: Dr. Jayanarayan Senapati1*, Dr. Rajashree Senapati2, Dr Dinesh Samel3, Dr. Anjani Senapati4

1Associate professor, Department of Obstetrics and Gynaecology, Rajiv Gandhi Medical College and ChatrapatiShivajiMaharaj Hospital, Mumbai, Maharashtra, India 2Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Senapati

Abstract
Background: In an attempt to reduce the rising trend of caesarean deliver worldwide, obstetrician now offer trial of labour more readily to women who have had a caesarean section. Although trial of labour is usually successful and safe, it may occasionally be associated with severe morbidity and even mortality. The objective of present research was to study the safety and efficacy of trial of vaginal delivery in women with previous lower segment caesarian section (LSCS) and to correlate it with maternal and perinatal outcome. Method: A total of 100 women with one previous LSCS admitted for a trial of labour after cesarean between years 1993 to 1995 at a Public Teaching Hospital and Medical College of Mumbai. Trial of scar and subjecting the patient to a vaginal delivery was done at 36 weeks and again at 38 weeks. The data of the mother was entered in register and analyzed statistically. Results: The incidence of vaginal deliveries following previous caesarean sections was 58 of 100 cases. Incidence of vaginal deliveries and repeat sections following one previous L.S.C.S. were 65.50 % and 43.50 % respectively. Following previous two L.S.C.S, the incidence of repeat sections and vaginal deliveries were 92.30 % and 7.7 % respectively. Nearly 62.86% of the patients of previous section for C.P.D. delivered vaginally during current labour and 37.14% delivered by repeat caesarean section. There was no major anaesthetic complication and no maternal mortality and minimal morbidity requiring not more than 15 days stay in hospital altogether. There was one case of perinatal death because of multiple congenital anomalies. Conclusion: Engagement of the presenting part of prior to the onset of labour is the single most significant prognostic factor for successful vaginal delivery.

Keywords: Trial of labour, lower segment caesarian section (LSCS), Incidence Morbidity, Mortality


Dr. Jayanarayan Senapati*
Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology.Grant Medical College,Cama and Albless hospital, Mumbai
Article Type : Research Article
Date : 2018-04-05
No of Downloads : 28