A comparative study of fetomaternal outcome of elective cesarean and vaginal birth after cesarean section in a tertiary care center in South India

Abstract

Aims and objectives: To provide evidence-based information to choose the mode of delivery following a single cesarean section in a tertiary center in South India. The objective is to study the success rate, safety, and efficacy of vaginal birth after cesarean section (VBAC) by comparing the maternal and perinatal outcome with the elective repeat cesarean section (ERCS). Materials and methods: This was a prospective, cohort study done over a period of 12 months in a tertiary care center. Based on the patients’ preference, a total of 211 women who satisfied the inclusion criteria were divided into two groups—either trial of labor after cesarean section (TOLAC) or ERCS group. Results: Success rate of VBAC was found to be 47.9%. About 15% of failed VBAC was due to the tendency to abandon TOLAC midway. Although the maternal complications were found to be higher in TOLAC, p value (0.347) was not found to be significant. There was no increased risk of neonatal morbidity and mortality in the TOLAC group when compared to ERCS (p = 0.814). There was also no difference found in Apgar scores (<7) at 5 minutes and newborn intensive care unit (NICU) admissions in the TOLAC group and in the ERCS group (p = 0.899). Conclusion: The success rate of VBAC was found to be 47.9%. There was no significant risk of maternal and perinatal complications compared to ERCS. Clinical significance: Although VBAC was found to be successful in developed countries, we need more of studies in our Indian setup with the local population to improve the quality of health care and create awareness among patients. This present study might boost the obstetricians in the tertiary care setup to counsel more for TOLAC.