A comparative study for feto-maternal outcome of trial of labour after caesarean: spontaneous versus induction

Abstract

Objective The purpose of this study was to compare the foeto-maternal outcome of trial of labour after previous one lower segment caesarean section in spontaneous and induced labour and to ascertain the success rate of VBAC.(Vaginal birth after cesarean section) Methods It was a prospective study conducted from May2019-November2020.The pregnant women admitted in BPSGMC (BPS Government Medical College), labour ward who had previous one caesarean section undergoing trial of labour after either spontaneous onset or induction of labour, were included in the study. Results Total patients were 130, [65 each, in group I(spontaneous) and group II (induced)]. Successful TOLAC (Trial of labour after cesarean section) happened in 80% in spontaneous labour (gp I) patients and 66.2 % women in induced patients (group II), (p value-0.075). There was no significant difference in age, parity and gestational age (p value >0.05), APGAR score and NICU (Neonatal intensive care unit) admissions in both spontaneous labour(gp I) and induced patients (gp II). There incidence of fetal distress was not statistically significant in spontaneous (group I) and induced patients (group II), (p value-0.744). Indication of primary LSCS (Lower segment cesarean section) showed no significant effect on outcome of TOLAC in spontaneous and induced group patients. History of prior vaginal delivery had more chances of VBAC. Hospital stay and PPH was more in induced patients(group II). The dfference of scar dehiscence in group I(spontaneous) and II (induced) were not statistically significant (p value=0.721). There were no cases of scar rupture in both the groups. Conclusion Induction of labour and spontaneous labour both have almost similar VBAC success rates. Also with fewer scar dehiscence and no rupture, IOL (Induction of labour) is a good option in previous one cesarean patients.