摘要
Background: The rising caesarean section rate worldwide is an increasing source of concern to all. A significant contributor to this is a previous caesarean delivery. One strategy in the armamentarium of obstetricians for reducing this is vaginal birth after one caesarean section (VBAC). The safety, outcome and complications of this procedure in our Center which is in a developing country had never been studied hence the need for this work. Aim: To find out the outcome and complications of vaginal births after one caesarean delivery in our Center. Method: A retrospective study involving a ten-year review of all cases of trials of labour after one caesarean delivery in our Center was done. Result: Of the 305 trials of labour after one caesarean delivery, 221 women had vaginal birth giving a vaginal birth after one caesarean section rate of 72.5%. Majority of the babies 303 (99.2%) were alive and had good Apgar scores while 2 (0.7%) died giving a perinatal mortality rate of 7 per 1000 babies. There were complications in 21 (6.7%) of the women with retained placenta, in 7 (2.3%) of the women as the commonest, followed by postpartum haemorrhage in 6 (1.96%). Five (1.62%) women had scar dehiscence while 3 (0.98%) had uterine rupture. Conclusion: Vaginal birth after one caesarean section is safe in well selected cases even in our resource poor settings. It offers our women a culturally-acceptable option of fulfilling long-held dreams of vaginal delivery even after one caesarean section and should be offered to our women whenever possible.
Background: The rising caesarean section rate worldwide is an increasing source of concern to all. A significant contributor to this is a previous caesarean delivery. One strategy in the armamentarium of obstetricians for reducing this is vaginal birth after one caesarean section (VBAC). The safety, outcome and complications of this procedure in our Center which is in a developing country had never been studied hence the need for this work. Aim: To find out the outcome and complications of vaginal births after one caesarean delivery in our Center. Method: A retrospective study involving a ten-year review of all cases of trials of labour after one caesarean delivery in our Center was done. Result: Of the 305 trials of labour after one caesarean delivery, 221 women had vaginal birth giving a vaginal birth after one caesarean section rate of 72.5%. Majority of the babies 303 (99.2%) were alive and had good Apgar scores while 2 (0.7%) died giving a perinatal mortality rate of 7 per 1000 babies. There were complications in 21 (6.7%) of the women with retained placenta, in 7 (2.3%) of the women as the commonest, followed by postpartum haemorrhage in 6 (1.96%). Five (1.62%) women had scar dehiscence while 3 (0.98%) had uterine rupture. Conclusion: Vaginal birth after one caesarean section is safe in well selected cases even in our resource poor settings. It offers our women a culturally-acceptable option of fulfilling long-held dreams of vaginal delivery even after one caesarean section and should be offered to our women whenever possible.
