Vaginal Birth After One Previous Caesarean Section (VBAC)

Abstract

Objective: To determine feto-maternal outcome and mode of delivery following one previous
caesarean section.
Material & Methods: This descriptive study was conducted in department of Obstetrics &
Gynaecology Unit-I Services Hospital, Lahore from June 2008 to June 2009. All patients with one
previous caesarean section due to non-recurrent causes with spontaneous onset of labour at
term were included in this study. Detailed clinical examination including abdominal and pelvic
examination and ultrasound for fetal well being and placental localization were done. Progress of
labour was monitored through Partogram. Fetal monitoring was done by auscultation and CTG.
Results:Among 200 patients included in this study 66.5% had vaginal delivery while 33.5% had
repeat caesarean section. Four scar dehiscence and one uterine rupture that was successfully
repaired were noted. Common indications for repeat CS were failed progress and fetal distress.
Conclusion: Atrial of scar may be given in all pregnant women with previous caesarean section
except those with absolute contraindications. A woman with one previous caesarean section
delivery with low transverse incision should be counseled and encouraged to attempt labour in
her current pregnancy in hospital with 24 hours facilities of operation theater and blood
transfusion services.