Outcome of trial of labor and scar in patients with previous caesarean section
Journal Title: Medpulse International Journal of Gynaecology - Year 2018, Vol 5, Issue 1
Abstract
Background: Rate of primary caesarean section have increased dramatically since the 1980s. Consequently, an increasing proportion of pregnant women attending for care have had a previous caesarean section and face the question of mode of delivery Aims and Objectives : To study Outcome of trial of labor and scar in patients with previous Caesarean section. Methodology: This was retrospective study of 156 cases of previous cesarean birth was conducted at Indian Institute of medical science and research, warudi, jalna from May 2015 to June 2017. Patients with Previous cesarean birth, previous one caesarean section for non-recurrent indication, Singleton fetus with Cephalic presentation were included into study while Post-datism with unfavorable cervix, Malpresentation, Pregnancy with PIH, Fetal distress, Clinical CPD, Bad obstetric history, IUGR, Previous two or more cesarean birth were excluded from the study. The details of the patients like morbidity, mean hospital stay, Perinatal mortality and Morbidity was retrieved. Result: Trial of scar was given in 85 patients, out of which 40% delivered, 51(60%) required repeat caesarean section. Out of 156 patients, 71(45.5%) cases were taken up for repeat caesarean section without trial of scar. Failed trial of scar in 16 study cases, required repeat LSCS in view of scar dehiscence or scar tenderness. Intraoperative dehiscence: 3.2%, Scar rupture: 0.64%. 31.25% patients had intra operative dehiscence on whom repeat caesarean section performed with provisional diagnosis of scar dehiscence. Conclusion: It can be concluded from our study that trial of labour after caesarean (TOLAC) in selected cases has great importance in the present era of the rising rate of primary caesarean section.
Authors and Affiliations
Mahesh Tandale, Swati Nagapurkar
Keywords
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