Analysis of trial of labour in previous one LSCS and its correlation with maternal and fetal outcome

Background: A rise in caesarean rate worldwide is one of the causes of maternal and perinatal mortality as well as morbidity. The goal of present study was to assess maternal and fetal outcome of patients with previous one LSCS who were given trial of labour. This research aimed to study the incidence of VBAC and repeat CS in cases with previous one LSCS. And to compare the fetomaternal outcome between vaginal and repeat caesarean delivery. Also, to discover factors predicting outcome of trial of labour after previous one caesarean delivery. Methods: In this prospective observational study in the Department of Obstetrics and Gynaecology of Grant Govt medical college and JJ group of hospital Mumbai,100 patients with previous one LSCS were evaluated over period of one and half years. Results: During the above period, out of 100 patients of previous 1 LSCS who were given trial of scar, 47 patients delivered vaginally and 53 required repeat LSCS. VBAC rate was higher in patient with history of previous vaginal delivery. Out of 53 cases who required repeat LSCS, scar tenderness was the most common indication followed by fetal distress. Complication rate were higher in LSCS group. NICU admission rate was higher in LSCS group. Conclusions: After careful selection of cases, trial of scar after previous one LSCS is safe and often successful. A prior vaginal delivery, Bishop Score > 6, estimated fetal birth weight <2.5 kg, spontaneous onset of labour, interconceptional period >3 years are associated with higher VBAC rate.