Evaluation of Reasons of Failure of Trial of Labor for Better Prognosis of VBAC

Abstract

Objectives The present study was conducted to determine the reasons of failure of VBAC after previous one 
caesarean section.  
Study Design: Descriptive type of study.  
Place and Duration of Study: This study was carried out in the department of obstetrics and gynecology Ayub 
Teaching Hospital Abbott Abad from 21 October, 2007 to 20 April,2008.  
Materials and Methods: The study population included 201 cases that were declared eligible for TOL having only 
one previous CS for non recurrent cause, a low transverse uterine scar, and adequate pelvis. All the findings were 
noted and recorded on predesigned proformas. Data was analyzed on SPSS version 10.Discriptive statistics were 
used to calculate Mean and standard Deviation for age, frequencies for abnormal lie, fetal distress, failure to 
progress, placeta previa, and other maternal or fetal causes of failed trial. Chi square test was used to test for 
significant difference of frequencies between groups; the student T test was used for significant 
Result A total of 201 patients with previous one caesarean section were admitted. VBAC was successful in 60 
patients, the rest i.e. 77 patients were given trial of labor but failed. Among them 20(26%) failure was due to scar 
tenderness in the prospective pregnancy, 15(19.5 %) patients had emergency lower segment CS for failure to 
progress, 8(10.4%) patients had another CS for fetal distress, 6(7.8%) had CS for impending rupture, 1(1.3%) had 
failed trial of labor due to rupture of uterus and 4(5.2%) had scar dehiscence.  
Conclusion: Results show that trial of labor in patients with previous one caesarean section due to non-recurrent 
causes is safe and has a success rate of 43.7%, which brings a hope to check the existing rate of CS.