ELECTIVE TRIAL OF LABOUR IN SINGLETON TERM PREGNANCIES WITH ONE PREVIOUS CAESAREAN SECTION

Background: Caesarean section rate has increased over the last three decades because of fear of scar dehiscence and uterine rupture in patients with previous caesarean section. This study was aimed to determine the maternal, fetal and neonatal morbidity and mortality during elective trial of labour in singleton term pregnancies with one previous caesarean section due to non recurrent causes. Material and Methods: This study was conducted at Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar from 1st January to 31st December, 2010. All patients with singleton term pregnancy with previous one caesarean section due to non recurrent cause with average size of baby were included. All the patients with placenta previa, contracted pelvis, induction of labour, elective caesarean section and previous uterine rupture were excluded from the study. Age in years, parity, period of gestation in weeks, mode of delivery, indications for emergency caesarean section, fetal outcome and maternal outcome were variables. Results: Out of 138 patients, the mode of delivery was vaginal in 78 (56.52%) patients and repeated lower segment caesarean section in 60 (43.48%) patients. Out of 78 vaginal deliveries, 56 (71.80%) were normal vaginal deliveries while 22 (28.20) were instrumental deliveries i.e. 20 (25.64%) were vacuum extractions and in 2 (2.56%) outlet forceps was used. There was one patient with scar dehiscence in the trial group but there was no fetal and maternal mortality. Conclusion: Trail of labour is a feasible option in women with one previous caesarean section due to non recurrent causes