Sanum Asif, Razia Kausar, Amina Saleem, Sameen Tahir.
Association of previous vaginal birth with VBAC (vaginal birth after C-sections).
Pak J Med Health Sci Jan ;13(4):827-9.

Background: The advent of painless birth with Caesarean section rate is increasing day by day. This raise the clinical suspicion that should a patient with previous scar uterus should given trial of labor or not as more than 50% caesarean section are done due to previous caesarean sections. Previous obstetrical history especially history of previous normal vaginal birth increases her chances of successful VBAC. It is evident that patient with pervious history of normal deliveries encourages to have trial of scar, as she has increase chances of having an eventful VBAC, in comparison with those patients who have no history of vaginal birth previously. Aim: Assessment of comparison between normal birth (vaginal) with VBAC. Study design: It is a descriptive comparative study Methods: It is conducted in six month duration in Nawaz Shareef social security hospital, from 1 march 2017 to 30 September 2017. 200 patient are being assessed for trial of scar. They are divided in two group. Those patient who are given trial of scar with history of previous vaginal birth (Group I). Those patient who were given trial of scar with no previous vaginal birth (Group II). In both group no induction is given. Those patient who came in spontaneous labor are assessed for trial of scar, with continuous monitoring with CTG, and all facilities for caesarean section if needed. Results: There is definitely much higher association of successful VBAC in patient with previous history of normal vaginal birth that is 76% as compare to 34% among patients who were given up trial of scar with no history of normal vaginal birth. This study clearly reflect that there is strong association between successful VBAC with previous history of normal vaginal birth. All patient who came in routine antenatal checkup, should be encouraged for trial of scar after one caesarean section provided her all parameter are full filled. These patient must be informed that they are saved from all the complication of operative delivery if they have successful VBAC. Conclusion: Caesarean section rate are increasing day by day and repeat caesarean section increase chances of maternal morbidity and mortality, in term of hospital stay, blood transfusion, increase chances of placenta previa, placenta acreta and definitely caesarean hysterectomy. So patient are properly councelled during their antenatal visits, those who have previous one caesarean section, whether previous history of vaginal birth or not should be encourged for trial of scar, as more than 85% chances of successful VBAC, if they are properly selected

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