TITLE:
Trial of Labour after Caesarean Section: A 5-Year Review
AUTHORS:
Francis Olayemi Adebayo, Rafat Bolanle Muhammad, Nathaniel Adewole, Adedeji Oyeniyi Adesope
KEYWORDS:
Trial of Labour after Caesarean Section, Vaginal Birth after Caesarean Section, Inter-Delivery Interval
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.12,
October
8,
2018
ABSTRACT: Background: Trial of labour after Caesarean section (TOLAC)
refers to an attempt at vaginal delivery after a previous caesarean section.
Outcome is influenced by a number of factors which are important in patient’s
selection. Objectives: The aim of this study was to find
out the incidence and feto-maternal outcome of the
practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of
cases of vaginal birth after Caesarean section Data were retrieved from the case notes
of patients who attempted vaginal birth after Caesarean section from January 1,
2013 to December 31, 2017, a period of five years. Result: There were
10,669 deliveries, 3179 of which were through Caesarean section. This gave a
Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal
birth after Caesarean section and 83 ended up as repeat Caesarean section
(38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section.
Patients with previous vaginal delivery, age range 25 - 29 years and interdelivery
interval of greater than or equal to 2 years were more successful at achieving
vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include
cephalopelvic disproportion (45.8%), poor
progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean
section was successful in most of the parturients that attempted it in this
study especially in patients within the age range of 25 - 29 years, those that have had
previous vaginal delivery and with interdelivery interval of greater than or
equal to 2 years.