Materials and methods
Women with previous caesarean deliveries visiting the hospital during their antenatal period were screened in their third trimester, and a well-informed consent was taken from those who fulfilled the inclusion criteria of the study.  A detailed  history was taken, and maternal characteristics ( age, parity,BMI any  prior vaginal delivery or prior VBAC indication of the previous CS, birth weight of the previous babies, and inter-delivery interval) were noted. Previous operative records were checked for the type of caesarean, gestational age, place of previous CS, type of closure, and for any related intraoperative or postoperative complications. On admission of the woman for delivery, the estimated gestational age, presence or absence of preeclampsia (PE), and gestational diabetes mellitus (GDM) were checked and recorded. Cervical examination findings were noted, and a decision for or against the need for an IOL was made. Women who needed IOL, were induced by intracervical insertion of an 18F Foley’s catheter under all aseptic precautions with the use of well-prepared and autoclaved Foley’s insertion sets. Women with a higher Bishop’s score were induced with oxytocin alone.
Maternal outcomes were assessed in the form of VBAC rate, CS rate, indication of repeat CS, methods of IOL used, rate of change of Bishop’s score at the end of cervical ripening, IDI (induction-delivery interval), reasons for TOLAC failure, rate of scar dehiscence or rupture, PPH (postpartum haemorrhage), need for blood transfusion, and any other maternal morbidity. Neonatal outcomes were assessed in the form of birthweight, 1 minute and 5 minute APGAR scores, the requirement of ventilation, admission to the NICU, or any other neonatal morbidity (minor or major) during the hospital stay. Enrolment and analysis of the study is explained in figure 1.