Abstract

Naushaba Rizwan, Saira Dars and Erum Sumreen Siddiqui

Vaginal birth after caesarean section is one of the strategies developed to control the rising rate of caesarean section. The objective of this study was to determine the frequency and fetomaternal outcome of vaginal birth in cases of previous caesarean section. The descriptive study was carried out in the department of Gynaecology and Obstetrics for the period of one year from January 2014 to December 2014. Selection criteria were women with normal pregnancy, adequate pelvis, vertex presentation and spontaneous onset of labour with previous uncomplicated caesarean section. Exclusion criteria were women with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy. All data collected was analyzed through SPSS 17.0 version. Frequencies and percentages were calculated for qualitative data. Results were presented by frequency distribution tables. Among 866 women admitted in labour ward fifty women were selected for VBAC. Majority of women (56%) belonged to age group 25-29 years. Regarding parity 74% were multigravida. The gestational age range between 38-40 weeks in 60% of women and only 10% had gestational age more than 40 weeks. VBAC was successful in 70% of women. Emergency caesarean deliveries were performed in 14(30%) of women due to fetal distress and prolonged labour. The cause of previous caesarean section was fetal distress in 34% of cases, malpresentation 24% prematurity 14% APH 10% and hypertensive disorder 12%. The Maternal complication included purepural infection 4%, prolonged hospital stay 4%, wound infection 4%, UTI 2%, pulmonary infection 2% and anemia 10%, fetal morbidities included Apgar score more than 7 in 74% and less than 7 in 24%, early neonatal death in 2%. Vaginal birth in patients with previous caesarean section is safe and open successful and should be offered to reduce the rising rate of caesarean section.