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Related Experiment Videos

Planned vaginal delivery after two previous caesarean sections

S K Chattopadhyay1, M M Sherbeeni, C C Anokute

  • 1Maternity and Children's Hospital, Riyadh, Saudi Arabia.

British Journal of Obstetrics and Gynaecology
|June 1, 1994
PubMed
Summary

A trial of labour after two caesarean sections is a reasonable option for selected women, with a high vaginal delivery rate and comparable complication rates to those not attempting vaginal birth. This supports informed decision-making for future pregnancies.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Vaginal birth after caesarean (VBAC) is a significant consideration for women with a history of caesarean sections.
  • The safety and efficacy of attempting vaginal delivery after two previous caesarean sections (CS) require careful evaluation.

Purpose of the Study:

  • To assess the outcomes of a trial of labour in women with two prior caesarean sections.
  • To compare complication rates between women undergoing a trial of labour and those opting for elective repeat caesarean section after two previous CS.

Main Methods:

  • A prospective observational study was conducted at a Maternity and Children's Hospital.
  • 115 women with two previous caesarean sections underwent a trial of labour, and their outcomes were compared to 1006 women with two previous caesarean sections who did not attempt a trial of labour.

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  • Key outcomes included vaginal delivery rates, scar dehiscence, uterine rupture, and other complications.

    • Main Results:

    • Out of 1136 women with two previous caesarean sections, 230 (20%) requested a trial of labour.
    • Of the 115 women accepted for trial of labour, 103 (89%) achieved vaginal delivery.
    • No scar dehiscences occurred in women who delivered vaginally; one scar dehiscence and one hysterectomy occurred after a failed trial of labour, with rates comparable to the non-trial group.

    Conclusions:

    • A trial of labour is a viable and reasonable option for carefully selected patients with two previous caesarean sections.
    • The high success rate and comparable complication profile support VBAC after two CS in appropriate candidates.