To compare the Fetomaternal outcome of natural birth versus induced birth after previous one caesarean section: A prospective Observational study

Background: Caesarean section is one of the most common surgery worldwide. In instances when there has already been a caesarean surgery, induction of labour is attempted very cautiously by the obstetrician. In this study we compare the fetomaternal outcomes of natural birth versus induced birth in previous caesarean antenatal women. Objectives: To compare the Fetomaternal outcome of natural birth versus induced birth in cases of previous one caesarean section. Patients and Methods: A one-year prospective study on 100 antenatal women who had lower segment caesarean sections in the past were planned at a tertiary care facility. The cases were split into two groups, with 50 going into natural birth and the other 50 being induced labour in a previous one caesarean section. Their fetomaternal outcomes were compared for the following factors in both groups: demographic profile, indication of prior caesarean delivery and induction in the current pregnancy, and safety profile for vaginal delivery. Results: The cases' demographic profiles were comparable, 52% of induced labour cases resulted in a vaginal delivery, compared to 78% of natural birth cases. The group receiving induced labour experienced a higher rate of repeat LSCS. Induced labour was more frequently associated with the need for augmentation of labour, mean duration of active labour (hours), and mother's hospital stay. In 22% of cases, induction was found to have failed. Both groups' prior vaginal deliveries were noted to be favourable variables for vaginal delivery. There was no difference between the two groups in the frequency of uterine rupture. Conclusion: Comparison of natural versus induced labour in previous one caesarean section showed comparable perinatal, maternal morbidity and mortality profiles and no increase in complications. Safe induction of labour can be tried with judicious selection of cases at a set up with facilities for emergency caesarean section.