Factor Contributing to Repeat Cesarean Delivery in Women with one Previous Cesarean Section

Abstract

Objective: To determine the maternal outcome in females undergoing trial of labor with previous one
cesarean section.
Material and Methods: A cross-sectional study was conducted at department of Obstetrics & Gynecology,
Central Park Teaching hospital, Lahore from June 2022 to January 2023 in which two hundred and fifty
females having previous one cesarean section were included in the study from labor room undergoing trial of
labor. Then females were followed-up in labor room till delivery and mode of delivery was noted. The
indications for current cesarean section, including maternal wish, short inter-pregnancy interval, failed progress,
fetal distress and impending rupture were also noted. All this information was recorded on proforma and analyzed
through SPSS version 21.
Results: In this study, 250 females were enrolled with mean age of 30.25±5.89 years, at mean gestational age
at delivery 38.91±2.24 weeks. The most common indication for previous cesarean section was fetal distress
170(68%), followed by Cephalo-pelvic disproportion 30(12%), failed induction 22(8.8%), failed progress
18(7.2%), breech pregnancy 7(2.8%), and placenta previa 3(1.2%). Successful vaginal delivery occurs in 120
(48%) cases, and cesarean section was repeated in 130 (52%) cases. The repeat cesarean section was done due
to following indications i.e. fetal distress 82 (32.8%), followed by failed progress [48 (19.2%)], short inter-
pregnancy interval 85(34%), impending rupture 32(12.8%), and maternal wish [21 (8.4%)].
Conclusion: Thus the chances of vaginal VBAC with trial of labor can be effective in reducing almost half
number of repeat cesarean sections.
Keywords: Vaginal birth after previous 1 cesarean section, normal delivery, fetal distress, failed progress,
maternal wish