Evaluation of Factors for Prediction of Trial of Labour and Outcome in Women with Previous CS

Objective: The objective of this study is the evaluation of factors for prediction of trial of labour and outcome in patient with previous CS.Patient and Methods: This study was performed on 784 selected pregnant women with previous one CS for trial of labour. These women were subjected to strict observation for progress of labour, intrapartum or postpartum maternal and fetal complication. Emergency CS was done for those women who show failure to progress in labour, fetal distress, undiagnosed CPD and for its others indications.Results: The success rate of Vaginal Birth after CS (VBAC) was 77.67%. The rate of VBAC in women below 20 and above 40 years was 44.6% and 39% respectively. Ages between 20-30 showed increased rate of VBAC (83.8%). Parity 2 or more and previous vaginal birth either before or after previous CS has higher rate of VBAC than those with no previous vaginal delivery. The success rate of VBAC in women with normal BMI is better than those in women with underweight, overweight or obese. Gestational age 37 weeks or less has better success rate of VBAC than full term or post date. The rate of vaginal birth was high if the previous indication for CS is not recurrent as the rate of VBAC for preeclampsia was 86.5% and for CPD was 63%. There was significant increase in anesthetic complication, blood transfusion, hospital stay and wound infection in the women with repeated CS than in the women with VBAC. There were no significant differences in the fetal complication between the two groups.Conclusion: The success rate of VBAC was 77.67%. Age, parity, previous vaginal birth either before or after previous CS, BMI, gestational age and the indication of previous CS were a good predictor factors for trial of labour in women with previous CS. In good selected women with previous one CS, vaginal delivery is safe and has less maternal complication than repeated CS.