Wednesday, January 7, 2009

103 out of 115 delivered VBAC after 2 Cesareans - How awesome if given the chance!

Author: Chattopadhyay-S-K. Sherbeeni-M-M. Anokute-C-C.
Title: Planned vaginal delivery after two previous caesarean sections
[see comments]
Source: Br-J-Obstet-Gynaecol. 1994 Jun. 101(6). P498-500. Comment:
Comment in: Br-J-Obstet-Gynaecol. 1995 Mar.102(3). P 262-3. Journal


OBJECTIVE: To determine the outcome of trial of labour after two
caesarean sections.
DESIGN: Prospective observational study.
SETTING: Maternity and Children's Hospital, Riyadh,Saudi Arabia.
SUBJECTS:Women with two previous caesarean sections considered
suitable for atrial of vaginal delivery.
MAIN OUTCOME MEASURES: The rates of vaginal delivery, scar
dehiscence, uterine rupture and associated complications among 115
women with two previous sections who underwent trial of labour were
compared with 1006 women with two previous sections who did not have
a trial of labour.
RESULTS: Trial of vaginal delivery was requested by 230 out of 1136
women (20%) who had two previous caesarean sections. Of the 115 women
accepted for the trial, 103 (89%)were delivered vaginally
. Labour
started spontaneously in 78 (68%)of the 115 women and was induced
with prostaglandin (PGE2) in the remaining 37. Augmentation of labour
with oxytocin was required in 32(28%) of the trial labour group.
There were no scar dehiscences among the women delivered vaginally.
There was one scar dehiscence and one woman required hysterectomy
after failed trial of labour, a frequency comparable to the
occurrence of these complications in women who did not have a trial
of labour.
CONCLUSION: A trial of labour in selected patients with two previous
caesarean sections appears a reasonable option.

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