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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
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Is vaginal delivery safe after previous lower segment caesarean section in developing country?
Pratiksha Gupta1, Ishrat Jahan1, Gelabhai R Jograjiya1
1Department of Gynaecology and Obstetrics, Post Graduate Institute Of Medical Sciences and Research Employees State Insurance, Basaidarapur, New Delhi, India.
Summary
Women with a previous caesarean section can safely attempt a trial of labour (TOL) for vaginal birth after caesarean (VBAC). Careful monitoring and counselling are key for successful VBAC outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Health
Background:
- Analyzing delivery modes in trial of labour (TOL) for women with a history of caesarean section (CS).
- Determining the incidence of successful vaginal deliveries and reasons for repeat CS.
Purpose of the Study:
- To evaluate the outcomes of trial of labour (TOL) in women with one previous lower segment caesarean section (LSCS).
- To assess the success rates of vaginal birth after caesarean (VBAC) and identify indications for emergency repeat CS.
Main Methods:
- Prospective study of 367 pregnant women with one prior LSCS.
- Group 1: Elective repeat CS (n=239). Group 2: Trial of Labour (TOL) with vaginal delivery (n=76). Group 3: TOL with emergency repeat CS (n=52).
- Maternal and fetal outcomes were analyzed using Chi-square and ANOVA.
Main Results:
- Out of 128 women in the TOL groups, 76 (59.37%) achieved VBAC.
- Of successful VBACs, 40 (52.63%) were spontaneous, and 36 (47.36%) involved labor augmentation.
- A total of 52 women (40.62%) required emergency LSCS after failed TOL.
Conclusions:
- Trial of labour (TOL) is a viable option for women with a previous caesarean section.
- Proper patient selection and counseling regarding risks are crucial for successful VBAC.
- Careful monitoring during TOL allows for timely intervention with emergency LSCS when indicated.
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