Title: OBSTETRIC OUTCOME IN VAGINAL BIRTH AFTER PREVIOUS CAESAREAN PREGNANCY (VBAC)
Abstract: AIMS & OBJECTIVES:-To study the factors affecting success of vaginal birth after caesarean section & to study maternal & fetal outcome after VBAC.METHODS:-The study included 248 women with previous one caesarean section at 38 completed weeks of gestation, without obstetric complications ,and were given trial of labor.Progress of labor, mode of delivery and maternal and fetal outcomes were noted and analysed.RESULTS: Out of 248 cases 66.1% delivered vaginally and repeat caesarean section was done in 33.9%.Out of 138 cases of Previous caesarean done for non reassuring fetal heart rate,74(53.6%)delivered vaginally.CONCLUSION: Good selection of cases and meticulous supervision during labor helps in successful VBAC. INTODUCTION:Pregnancy with previous caesarean section is quiet prevalent condition .This is due to liberalization of primary caesarean section for non-recurrent indication.Caesarean section rates has increased from 21.8% in 1993-1994 to 25.4% in 1998-1999 1 ,leading to increasing number of women with previous caesarean section in subsequent pregnancy and labor.Post caesarean pregnancy is a high risk case and had scrupulous supervision during antenatal period and labor.The dictum "once a caesarean, always caesarean" no longer applies.Women who have previous caesarean delivery can safely attempt a trial of labor to have vaginal delivery in subsequent pregnancies.Vaginal birth after caesarean (VBAC) is possible but is associated with risk and need supervision.Caesarean section is associated with maternal morbidity.Maternal complications include hemorrhage, infection, pulmonary embolism, DVT.Major benefit of VBAC is reduction in maternal morbidity, avoiding uterine incision, lower cost.VBAC is associated with various complications and risks such as scar dehiscence, rupture uterus, perinatal morbidity and mortality, hysterectomy, unsuccessful trial of labor requiring emergency caesarean section.Major factors influence the success of TOL such as indication of previous caesarean section, previous normal delivery, site & type of scar, no. of caesarean section.Our study was done to know the factors affecting & obstetric outcome in vaginal birth after previous caesarean section.Trial of