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Subjective assessment of lscs scar site for vaginal birth after caesarean trial and outcome in mgims, sevagram, wardha, india

Authors:Pramod Kumar, Poonam Varma Shivkumar, Arpita Jaiswal, Naina Kumar, Kavita Saharan
Int J Biol Med Res. 2012; 3(2): 1825 – 1829  |  PDF File

Abstract

Abstract: The objective of this study was to determine the final outcome of a trail of scar by subjective assessment of LSCS scar site and vaginal birth after caesarean section (VBAC), and develop guidelines to reduce the unnecessary repeat caesarean rate. Method:This study was carried out in Obstetrics and Gynaecology Department of MGIMS, Sevagram, Wardha, India from 01/11/2008 to 31/10/2011. A total of 13, 175 parturient were delivered during this period, out of which 1485 cases had history of one previous caesarean section. A total of 249 patients had an elective repeat caesarean section and rest of 1236 were subjected to a trial of scar. Result: 1236 patients selected for trial of scar, 846 (68.4%) had a successful uncomplicated vaginal delivery, 65(5.2%) were delivered by vacuum extractor, 38(3.2%) required a repeat emergency caesarean section, 73.9% of the babies were born with Apgar score 78 and 24.8% had an Apgar score between 6-8. There were none cases of scar dehiscence and rupture uterus and one baby was lost due to congenital malformation. Conclusion:More than 76% of the parturient with one previous caesarean section for non-recurrent cause can be successfully delivered. Antenatal booking and follow up, careful case selection for trial of scar and close observations during labour will achieve successful maternal and perinatal outcome.