Farva Hasan, Syeda Batool.
Vaginal birth after two previous cesarean sections.
J Surg Jan ;27(1):62-4.

A 35 year old G7 P6+1 who had two previous caesarean sections had undergone four successful vaginal births. In 1993 her first c-section was done at full term for failure of labor to progress and fetal distress. In her second pregnancy she was keen for vaginal delivery she had spontaneous onset of labor at term followed by trial of labor but due to fetal bradycardia & impending rupture c-section was done. In her subsequent pregnancies she had spontaneous vaginal delivery after spontaneous onset of labor at term. In her seventh pregnancy, at 38 weeks of gestation, she had rupture of membrane in evening at home; followed by mild to moderate pains in morning. She was taken to a lady health visitor, who started augmentation with syntocinon but no FHR monitoring was done. Female child with poor APGAR score was delivered. Baby was gasping at that time and expired later. She then presented with heavy per vaginal bleeding and was referred to PIMS. In the hospital she received medical management of PPH, USG showed intact scar. One pint of blood was transfused after which patient condition stabilized and was discharged on second day of admission.

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