Assessment of outcome of Trial of Labour after caesarean in a tertiary
hospital based setting : Prospective Observational Study
Abstract
Objective: To determine the success rate of vaginal birth after
caesarean (VBAC) in Indian women, identify the factors that predict its
success, and assess the maternal and neonatal outcomes following a trial
of labour after caesarean (TOLAC). Design: Prospective observational
study Setting: Department of Obstetrics and Gynaecology, Post Graduate
Institute of Medical Education and Research, Chandigarh, India Sample:
124 women with previous LSCS who opted for TOLAC Methods: A prospective
observational study involving women with one previous lower segment
caesarean section (LSCS) who were admitted for TOLAC between January
2019 and June 2020. Main outcome measures and Results: During the study
period, 124 women with previous LSCS who opted for TOLAC were included,
of whom 68 (54.8%) had successful VBAC and 56 (45.2%) had failed
TOLAC. The induction of labour (IOL) rate in the study was 69.4%, and
30.6% of women had spontaneous onset of labor. VBAC rates were
significantly higher in women who went into labour spontaneously (84.2%
vs. 15.8%). Maternal complication rates were comparable, whereas the
neonatal complication rate was significantly higher in neonates born by
CS (51.7% vs. 30.8%), with a greater incidence of low birthweight
(LBW) and transient tachypnea in the newborn (TTNB). Conclusions: TOLAC
can be considered a safe option for women with a previous caesarean when
combined with vigilant and stringent labour monitoring, despite the use
of IOL agents. Funding : Not applicable.