Bilqees Iftikhar Khawaja, Saimaghaffar, Chandra Madhu Das, Raheela Bilal Shaikh.
Vaginal birth after caesarian section - a revisit.
Med Channel Jan ;17(3):39-41.

Background: vaginal delivery after caesarian section needs to be encouraged in patients who are willing to do it but with proper care and under expert care. Success rates of labour after caesarian section are also varied with differently reported mild risk of uterine rupture. This study was done to evaluate the patients undergoing vaginal delivery after caesarian section in our setup. Methodology: This multicenter, single protocol, prospective observational study was conducted on one hundred twenty three patients from Jan 2009 to Dec 2009 after obtaining informed consent in the Departments of Obstetrics and Gynecology, Muhammad Medical College, Mirpurkhas and Liaquat University of Medical & Health Sciences, Jamshoro, having normal pregnancy, clinically normal pelvis dimensions spontaneous onset of labour, normal presentations are selected for trial of labour. Results: In this study oblique lie was found in 6 (4.87%) patients. Transverse lie was seen in 17 (13.82%) of patients, placenta previa was seen in 21(17.07%). Thirty one (25.50%) failed to progress so they were underwent caesarian section. Breech presentations were seen in 7(5.69%). The rate of scar dehiscence seen higher in lower uterine segment with vertical incision and seen lower in transverse incision. So this is a good indicator for safety of labour after caesarian section, is location of uterine scar. The success rate and fetomaternal outcome is comparable in studies carried in other countries. Conclusion: Trail of labour is given only after one caesarian section and should be given at place where all facilities are available along with judicious fetomaternal monitoring and care.

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