Malahat Mansoor, Sunbal Kashif.
To study uterine rupture & fetal distress in patients with previous LSCS.
Pak J Med Health Sci Jan ;4(2):105-8.

Background: With increasing operative deliveries i.e. Caesarean sections in obstetrics, management of subsequent pregnancies has become a challenge among, Obstetricians, as on one hand, repeat caesarean deliveries are associated with servers morbidities like placenta previa, adherent placenta, adhesions, infections and on the other hand vaginal birth after caesarean section (VBAC) is associated with uterine rupture, fetal distress, and scar dehiscence etc. Objective: To study uterine rupture and fetal distress in patients undergoing trial of labour (TOL) with previous caesarean section. Materials & method: One hundred pregnant patients with only one previous section attending antenatal clinic in Services hospital, Lahore were included. Patient in which there was no contra indication to vaginal birth, no significant medical or surgical problem affecting mode of delivery were included. Both the patient and her husband were explained pros & cons of trial of labour (TOL) in previous section and they consented to VBAC. Labour either spontaneous or induced, was included with all arrangements of an emergency caesarean section with strict feto-maternal monitoring and with maintenance of partogram. Results: It was found that out of 100 patients 4 (4%) had uterine rupture and 10 (10) fetuses had fetal distress & 1% baby expired. 67% of patients were between 31-40 years of age. Blood transfusion was observed in 12(12%) patients. Conclusion: Although VBAC is a better choice for women with previous one caesarean section, a better antenatal evaluation with exploration of her previous record is essential . Labour must be vigilant with arrangements of blood and emergency operative delivery.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com