ELECTIVE TRIAL OF LABOUR IN SINGLETON TERM PREGNANCIES WITH ONE PREVIOUS CAESAREAN SECTION

Objective: To study maternal, fetal and neonatal morbidity and mortality during elective trial of labor in singleton term Pregnancies with one previous caesarian section due to non-recurrent causes. Material & Methods: This study was conducted in the Department of obstetrics and gynecology, Lady Reading Hospital Peshawar, from 1st January to 31st December, 2010. A total of 173 singleton term pregnant women with previous one caesarean section due to non recurrent cause were recruited in the study. All the term pregnant women with cephalic presentation, normal size babies and clinically adequate pelvis were included in the study. All the patients with multiple pregnancies, malpresentation, placenta previa, contracted pelvis, induction of labor, previous 2 caesarian section, election caesarean section and previous uterine rupture were excluded from the study. Results: Total deliveries during this period were 4755. Total patients admitted with previous one caesarean section were 173. Five patients were received with ruptured uterus and thirty patients had elective lower segment caesarean section and they were excluded from the study while 138 were found suitable for the trial of labor. Of these, 138, 78(56.52%) patients delivered vaginally while 60 (43.47%) were delivered by repeat emergency lower segment caesarean section. There was one patient with scar dehiscence in the trial group but there was no fetal and maternal mortality. Conclusion: Trial of labor in selected patient with previous one caesarian section is associated with high vaginal birth rate and decreased risk of scar dehiscence, ruptured uterus and fetal death.