The Frequency of Vaginal Birth after one Cesarean Section with Vigilant Fetal and Maternal Monitoring

Objective: To observe frequency of vaginal birth after one C-section with vigilant fetal/maternal monitoring. Design: Descriptive study. Place and duration of study: The present study was conducted in District Head Quarter Hospital Okara between April 2011 and Aug 2011. Method: A total number of 92 patients of the age of 18-40 were studied. These patients with the term pregnancy i.e. between 37 to 42 completed weeks of gestation and history of one cesarean section were randomly selected who admitted to Obstetrics and Gynecology department. Baseline investigation was performed and obstetric ultrasonography was preformed to watch the thickness of previous scar and fetal well being. All patients then allowed proceeding for spontaneous labor. Results: 92 Patients were enrolled in this study that filled the selection criteria. 64/92(70.7%) patients were delivered vaginally after previous one cesarean section and 28/92(29.3%) patients had emergency cesarean section. Among vaginal delivery 38/92(41.3%) patients had normal vaginal birth and outlet forceps were applied on 14/92(15.2%). Out of 28 patients who handed up on cesarean section, 13% had fetal distress, 9.8% patients showed failure to progress. Cesarean section due to scar tenderness was done in 6.5% and scar dehiscence was seen in 2%.