Abstract: Introduction: Caesarean section has evolved from it being done in desperate situations as a post-mortem surgery to save the unborn child to present times where one of the commonest indications is previous caesarean birth. VBAC is associated with decreased rate of caesarean section as well as prevents the woman to subject themselves to major surgical procedure with all the inherent risks associated with it. The aim is to study the outcome of labour in post caesarean pregnancy and to study the clinical condition of previous caesarean scar
Materials and methods: This study was done among 100 women at Sri Siddhartha Medical College between January to December 2024. Inclusion criteria were all term pregnant women with history of single uncomplicated lower segment caesarean section done for non-recurrent indication. Before an attempted trial of labour patients were explained risks, benefits and alternatives to the procedure. Signs of scar dehiscence were watched for and Intrapartum foetal monitoring was done with the help of Cardiotocography
Results: This study included 100 patients. The commonest indication of primary section was cephalo pelvic disproportion (29%) followed by foetal distress (15%), Pregnancy induced hypertension (13%) and non-progress of labour (10%).Among 100 cases studied 80 has undergone caesarean section, 20 was delivered vaginally. 65 cases were taken directly for repeat emergency caesarean section without any trial for vaginal delivery due to various obstetrical risk factors, 35 cases were given TOLAC.
Conclusion: VBAC is a safer alternative to conducting ERCS in the developing countries like ours. Repeat CS and planned VBAC are both associated with benefits and harms. To reduce overall caesarean section rates & prevent repeat CS, vaginal delivery should be anticipated, but only in favourable cases with meticulous monitoring. The outcome of VBAC is not associated with increased morbidity and mortality for both babies and mother.
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