Author(s): Uma B. Deshmukh1, Jayashree R. Swamy2
INTRODUCTION: There has been a significant increase in the number of primary caesarean section in recent times, and therefore, the number of women with a pregnancy after a prior caesarean section has also increased.1 The effective and safe use of caesarean section as a mode of delivery has received a lot of attention since decades. The National Institutes of Health (NIH) held a Consensus Conference on Caesarean Childbirth in response to concerns about a three-fold increase in the rate of caesarean deliveries in the United States, based on which they proposed vaginal birth after caesarean (VBAC) as a mechanism to reduce the use of caesarean section.2
Recent reports have shown that VBAC is a reasonable and safe choice for the majority of women with prior caesarean, and after clinical assessment, appropriate subjects, after assessing the risk: benefit ratio can be considered for a trial of labour.2, 3, 4
According to the results of a systematic review by Brill and Windrim, a non-recurrent indication for previous caesarean section, such as breech presentation or fetal distress, is associated with a much higher successful VBAC rate than recurrent indications like cephalopelvic disproportion (CPD). Prior vaginal deliveries are associated with excellent prognosis of successful VBAC, especially if they follow the prior caesarean section.5
We undertook the current study to analyze the outcome of labour following previous caesarean section.