Maternal and fetal outcome in pregnant women with previous one lower segment cesarean section

Abstract

Background: Cesarean section is one of the most commonly performed abdominal operations on women. Because of increasing incidence of Cesarean sections the no. of patients with previous 1 LSCS is also increasing. Thus proper antenatal counseling and institutional delivery should be done. Methods: A prospective observational study was conducted at department of Obstetrics and Gynaecology, LLRM Medical College Meerut during one year period from Nov 2015-May 2016. Participants to study the maternal and fetal outcome in pregnant women with previous one LSCS. 200 pregnant women were included in the study and outcomes were studied. Results: Maternal Outcome: Out of 200 cases 122 patients underwent vaginal birth after Cesarean (VBAC) accounting for 61% and 78 patients underwent 2nd LSCS (76 emergency LSCS and 2 elective LSCS). Out of 76, 55 patients were given trial of VBAC but failed and end up in C-Section showing success rate of 68.92% for VBAC (122 out of 177). Adhesions were found in 21patients out of 78 (26.92%) who underwent LSCS. Uterine rupture seen in 2 patients out of 200 cases (1.0%). Scar dehiscence was seen in 6 out of 78 patients (7.69%). Post-partum Hemorrhage was seen in only 20 (10%) patients. Pre-term Pregnancy occurred in 16 (8%) patients. Caesarean Hysterectomy had to be done in 3 (1.5%) patients. Placenta Previa was seen in 6 out of the 200 patients (3%) and placenta accrete was seen in 1 patient (0.5%). Out of 200 patients, 2 twins were born. The total number of babies born was 201. 8 IUDs occurred out of 201 babies (3.98%) and a total of 25 out of 193 live babies (12.95%) required admission to Neonatal Intensive Care Unit out of which 2 babies died. Conclusions: Cesarean section should not be always followed by a repeat cesarean section. Patient should have hospital delivery in a well-equipped hospital and complications should be diagnosed at an early stage so that maternal and perinatal morbidity and mortality could be prevented.