VAGINAL BIRTH AFTER PREVIOUS ONE CAESAREAN SECTION: TERM PREGNANCY OUTCOME

Objective: To find out the out come of term pregnancy in women with previous one caesarean section.Material and Methods: This descriptive type of study was conducted in the department of Obstetrics and Gynaecology, Gynae "A" unit, Postgraduate Medical Institute, Reading Hospital Peshawar from January 1998 to December 1999. During this time period, 211 patients were selected to be included in the study It included all patients with previous one caesarean section with 37 completed weeks or above. All patients with gestation less than 37 completed weeks, previous more than one caesarean section or scarred uterus due to some other cause were excluded form the study.Results: Patients were divided with previous caesarean section for recurrent or non-recurrent cause. Total patients with former indication were 90 (42.65%). Out of these 28.9% (n=26) were delivered by elective repeat caesarean section, 47.8% (n=43) had emergency repeat caesarean section and 23.3% (n=21) had vaginal delivery. Total patients with non-recurrent cause for previous caesarean section were 121 (57.35%). Out of these 121 cases, 76 cases (62.8%) were delivered vaginally and 42 cases (34.71%) by emergency repeat caesarean section due to failed-VBAC (Vaginal birth after caesarean section) and 3 cases (2.48%) had elective c-section. The study also revealed perinatal mortality of 14.12% in emergency repeat caesarean section group. These were more pronounced in women having unmonitored trial of labour outside the hospital.Conclusion: It is concluded that well monitored trial of scar leads to increased percentage of vaginal deliveries, which is a contribution towards bringing down the rising caesarean section rate.