STUDY OF MATERNAL AND FETAL OUTCOME AND FACTORS AFFECTING SUCCESS WITH VAGINAL BIRTH AFTER CESAREAN SECTION IN TERTIARY CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2014, Vol 3, Issue 3
Abstract
Cesarean section must be justified only when benefits outweigh harm to the mother and fetus. The impact of Cesarean section on maternal and child health and its high cost compared with vaginal birth represent a public health problem. Cesarean section rate is increasing globally and reported to be 25-30% in recent studies. Several factors contribute to this increase, but repeat CS stands as the most relevant factor and contribute to about 29% of performed CS. One of the strategies proposed to reduce the CS rate is to increase the number of trials of labor among women who had previous one lower segment cesarean section. However, concern still remains regarding associated maternal or neonatal complications and factors that lead to success or failure of VBAC. So, we undertook this study to evaluate the factors affecting success of VBAC. [b]AIMS AND OBJECTIVE:[/b] To study maternal and fetal outcomes associated with trial of vaginal birth after cesarean section and to evaluate factors associated with its success. [b]MATERIALS AND METHODS[/b]: It is an Observational prospective study performed on 100 parturients in the department of OBG, in Mamata General Hospital, Khammam, Andhra Pradesh. Patients with previous one lower segment Cesarean section and a single fetus with cephalic presentation without cephalo-pelvic disproportion were included in the study. These women were given a trial for vaginal birth with observation during labor by a partogram and external fetal cardiotocography.[b] RESULTS[/b]: Vaginal birth was successful in 50%. Repeat Cesarean section was done in the other 50% due to suspicious scar (62%), fetal distress (24%) and failure to progress (14%). Scar Rupture occurred in (6%), postpartum hemorrhage in (4%), neonatal incubation in (10%) and the neonatal mortality was (2%). Vaginal birth was significantly higher in the age group 20-30 years, body mass index in between 20-25, patients with prior vaginal birth, inter-pregnancy interval more than one year, previous CS done for a nonrecurrent cause, parturient admitted with cervical dilatation more than 4cm, gestational age in between 37-40 weeks and birth weight of 2500-3000 gm. [b]CONCLUSION:[/b] Safe vaginal birth after Cesarean section requires good antenatal care, strict selection criteria and close supervision during labor. Appropriate incubation and neonatal care are essential to decrease neonatal risks
Authors and Affiliations
Vijayasree M, Prabhakar G. C, Sivarama Krishna, Gopichand K, Satish Pathak
Keywords
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- EP ID EP117277
- DOI 10.14260/jemds/2014/1867
- Views 83
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