Mehr Un Nisa, Lubna Hassan.
Trend of vaginal delivery after one previous Cesarean Section in a tertiary care hospital.
Pak J Med Res Jan ;43(2):60-4.

Objective: To find factors indicating success in vaginal delivery after one C-section in a tertiary care hospital where sophisticated monitoring devices are not available and only manual monitoring are relied on. Design: This was a case control study in which data from the ward record were collected retrospectively and fed to SPSS data file. All analyses were done in the same SPSS program version 10.0 Place & Duration of study: The study took place in the Department of Obstetrics and Gynaceology, Hayatabad Medical Complex, Peshawar from January 2000 to December 2001 both months inclusive. Patient and methods: All patients who had history of one previous C-section and presented with subsequent pregnancy, were included in the study. Induction of labour was not part of this study and those patients who had more than one C-section were excluded from the study. Patients were allowed to go into spontaneous labour only if it was safe. If patients resisted C-section, they were allowed to wait only till 41 weeks of gestation. Results: Of a total of 257 patients of the study, 86 patients (33.5%) delivered vaginally, assisted or unassisted. The only factor statistically significant which would favour successful vaginal delivery was history of previous vaginal delivery prior to the previous C-section. Patients who underwent previous C-section because of either bad obstetrical history or Chorioamnionitis, universally delivered through C-section. Conclusion: Patients who had once previous C-section but had previously delivered vaginally, have more chances of successful vaginal delivery than others. If the indications for previous vaginal delivery were Bad obstetric history or chorioamnionitis, little can be achieved from trial of scar. If the previous C-section was carried out for cephalopelvic disproportion, there was 1/3 chance of successful vaginal delivery in the present pregnancy.

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