TRIAL OF LABOR

SUCCESS IN WOMEN WITH PREVIOUS CAESAREAN SECTION

Abstract

Objective: To determine the frequency and types of vaginal delivery in women
with previous one caesarean section and to observe the effect of women age on success of
vaginal birth. Method: A descriptive study was carried out in the department of obstetrics
& gynecology, Ziauddin University Hospital Kemari campus Karachi from January 2011 to
January 2013. 200 patients with previous one caesarean section for a non recurrent cause were
included in the study after fulfilling the inclusion and exclusion criteria. The women selected
were evaluated and counseled for trial of labor. The frequency and mode of vaginal delivery was
recorded in cases of successful trial of labor and caesarean section was performed in case of
failed trial of labor. Results: Successful vaginal delivery was achieved in 67% of the patients and
repeat emergency caesarean section was carried out in 33% of the patients. Leading indication
for repeat caesarean section was failure to progress, fetal distress and scar tenderness. No
maternal and fetal complication occurred. We also observed that patients of less than 30 years
were more likely to have a successful vaginal delivery (82%) as compared to patients older than
30 years (18%). Conclusions: The trial of labor should be encouraged with vigilant monitoring
in patients with previous one Caesarean section and is a safe and successful option if carefully
selected and monitored.