Maternal and fetal outcome in vaginal birth after caesarean section in a tertiary care teaching hospital in South India.

Usha Brindhini M; Malathi Jonna; Vanaja Kandluri; Rathnamala M Desai

Volume : IX, Issue : IV, April - 2020

Maternal and fetal outcome in vaginal birth after caesarean section in a tertiary care teaching hospital in South India.

Usha Brindhini M, Malathi Jonna, Vanaja Kandluri, Rathnamala M Desai

Abstract :

Background: Caesarean section is the most common procedure performed during reproductive age group with rates continuing to rise worldwide. One of the most common indication for repeat cesarean section is previous caesarean birth. The proportion of women attempting a vabginal Birth after Caesarean section (VBAC) is reducing in many countries nowadays, because of negative thought of an increase in the risk of maternal and infant complications related to VBAC. Our aim was to study Maternal and Fetal Outcome in VBAC in a tertiary care teaching hospital. Materials And Methods: This is a cross sectional study conducted from the patients attending the labour room and outpatient in the department of Obstetrics and Gynecology for one year. Inclusion criteria included Women with one previous lower segment cesarean section, Singleton pregnancy, Cephalic presentation, Term gestation. Women having two or more caesarean sections, Teenage pregnancy, Previous uterine surgery like myomectomy, Estimated fetal weight >4 kg, Interdelivery interval <18 months, Classical section, Termination of pregnancy for anomalous baby were excluded. A total of 80 cases were selected either from the outpatient department (booked) or in labour (unbooked). The study was done after obtaining clearance from Institutional Ethics Committee and after getting informed consent from the study population. Results : In our study, among 80 study subjects, most people are in the age group of 20–25 (47.5%), 52 (65%) were booked case . The causes for primary cesarean section group were found to be fetal distress 18 (22.5%). Spontaneous onset of labour was seen in 87.5% of patients. Duration of labour was >4 hrs in 66(82.5%) patients. We had 77.5% of successful VBAC with spontaneous delivery in 42(52.5%) of VBAC group. The most common cause for failed VBAC is scar dehiscence. Among neonatal outcome, 12.5%) had respiratory distress. 90% of baby had apgar score >7/10 at first minute, at 5th minute 97.5% had apgar of >7/10. Conclusion: Our study revealed that VBAC is a safe method selected cases which has great importance in the present era of the rising rate of primary caesarean sections. Vaginal birth after one Caesarean section is safe with good antenatal care.