Rakhshan Shaheen Najmi.
Factors determining route of delivery following one Cesarean Section.
J Coll Physicians Surg Pak Jan ;9(1):20-3.

A study was carried out at Sir Ganga Ram Hospital, affiliated with Fatima Jinnah Medical College, Lahore to determine the mode of delivery following one C-section and to establish significance of different factors influencing the outcome. During the study period a total of 469 cases came with one previous C-section, of these 233 (49.68%) were selected for repeat section and 236 (50.32%) were subjected to trial of scar which was successful in 141 (59.75%) delivered vaginally. About 45% (212/469) of patients who had previous C-section for foetal distress, failure of progression of labour and CPD had repeat Caesarean section. Presence of some complication in index pregnancy and/or outside malhandling contributed to the decision of doing repeat C-section in 233 (49.68%) cases without allowing them to undergo trial. Factors which favoured vaginal delivery after trail of labour included previous section because of malpresentation, spontaneous onset of labour, favourable bishop score (5-6) and foetal weight less than 4 kg while poor bishop score (<4) and foetal weight more than 4 kg were linked with unfavourable outcome (p<0.05).

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