Open Journal of Obstetrics and Gynecology

Volume 2, Issue 3 (September 2012)

ISSN Print: 2160-8792   ISSN Online: 2160-8806

Google-based Impact Factor: 0.37  Citations  h5-index & Ranking

Optimization of clinical outcome of women with previous one lower segment cesarean section

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DOI: 10.4236/ojog.2012.23055    4,897 Downloads   7,625 Views  Citations

ABSTRACT

Background and Objectives: To investigate the outcome in women with planned (VBAC) in comparison to Repeat Cesarean Section (RCS) and to those undergoing vaginal birth. Design and settings: Retrospective study, women with a history of one lower segment cesarean section (LSCS) admitted to Abha General Hospital for delivery from September, 2010 to February, 2011. Subjects and Methods: The demographic maternal and neonatal data and data concerning the course of delivery were reviewed in 418 women underwent trial of labor (TOL) and subjected to statistical analysis to study the predictive factors and outcome. All cases were divided into 3 groups, VBAC group (212 women), RCS group (206 women) and the neonates of the VBAC group were compared to those of a control group consists of 287 neonates who delivered vaginally. Results: The success rate of VBAC was 50.72%, with no uterine rupture or wound dehiscence. Failure to progress was the most common (40.2%) indication of RCS followed by fetal distress (29.9%). Young maternal age (P < 0.05), previous vaginal deliveries after CS (P < 0.05) and occiputo anterior position (P < 0.01) were significantly associated with successful VBAC. Neonatal Intensive Care Unit (NICU) admission was significantly higher in the RCS group (P < 0.001), while no significant difference was found between NICU admission in the VBAC and the control groups. Conclusion: VBAC should remain an available option. Informed consent, good reporting and thorough documentation of the VBAC decision are crucial. During TOL, continuous fetal monitoring and, ultrasound evaluation of the previous scar are recommended. Emergency CS should be considered if duration of the TOL is prolonged with non reassuring CTG.

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Eskandar, M. , Aboud, J. , Alshahrani, M. , Hassanein, M. and Alyamani, A. (2012) Optimization of clinical outcome of women with previous one lower segment cesarean section. Open Journal of Obstetrics and Gynecology, 2, 265-269. doi: 10.4236/ojog.2012.23055.

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