Study of factors associated with success of vaginal birth after previous one caesarean section

To study the factors associated with vaginal birth after one cesarean section, to evaluate fetal and maternal outcome in VBAC deliveries, It is a case control prospective study conducted in department of Obstetrics & Gynecology, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior (M.P.) from November 2013 to October 2014. Inclusion criteria: Previous 1 LSCS, No contraindication to trial of labor (No obvious fetopelvic disproportion), Patient came with spontaneous labor. Exclusion criteria:-Contraindication to trial of labor. (Obvious fetopelvic disproportion) Any other uterine scar like myomectomy, hysterotomy, and High risk pregnancy. Sample size: 200, Cases: Patient who delivered through cesarean section after trial of labor. Control: Patient who delivered through vaginal route after trial of labor. In present study, success rate of VBAC in age group of > 35 years is small (p value = 0.001) which is statistically significant. In present study rate of VBAC was higher if indication of previous CS included mal presentation and fetal distress and MSL. Rate of ERCS was higher when indication of previous CS was failure to progress (p value = 0.0001). Patients who had NPOL in previous pregnancy, inter pregnancy interval is < 2 years (p value <.001) has decrease success rate of VBAC. The most common cause of failure of trial of labor was non-progress of labor (48%) patients having history of vaginal delivery after CS have more chances of successful VBAC in this pregnancy (60.7%) compared with women whose vaginal delivery was prior to caesarean delivery (39.3%). Present study shows that with increasing neonatal birth weight chance of successful trial of labor is reduced in more chances of babies to get admitted in NICU if delivered vaginally in cases of previous CS.