DOI: 10.36347/sjams.2016.v04i07.002

Pages: 2318-2321

An attempt has been made to undertake to study maternal morbidity and mortality in 100 cases of post caesarean pregnancies keeping the objectives like risks of pregnancy, outcome of labour, maternal morbidity and mortality and foetal outcome in cases with history of previous caesarean section. The study was conducted on 100 selected cases in the department of Obstetrics & Gynaecology, Gauhati Medical College and Hospital, Guwahati who regularly attended outdoor and admitted at term, those who were booked in antenatal clinic but admitted as emergency and those who never attended the antenatal clinic but admitted as emergency, over a period of 1 year w.e.f January 2015 to December 2015. Out of 100 women, 32 cases were selected for vaginal delivery. Of them, 20(62.5%) had vaginal birth after caesarean (14 spontaneous, 4 forceps and 2 ventouse delivery). Repeat caesarean section were performed in 12(37.5%) cases after failure of vaginal delivery. Antepartum complications like anaemia (69.72%), antepartum haemorrhage ( 5.5%), pregnancy induced hypertension ( 2.75%), intrauterine growth retardation ( 2.75%), oligohydramnios ( 5.5%), postdatism (4.59%) and premature rupture of membrane (1.83%) were seen in this study. During labour, 5 patients had scar tenderness and 1 patient had postpartum haemorrhage. 1 patient died after ventouse delivery due to broad ligament haematoma. Maternal mortality was found in 1(1%) patient in this study. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal delivery. In carefully selected cases under strict supervision, trial of labour (TOL) after prior caesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful vaginal delivery.