Maria Aslam, Mehak Asim Khan, Filza Habib, Hasina Sadiq, Maria Habib, Munazza.
Outcome of pregnancy in previous cesarean section comparing elective versus trial of labor (VBAC) at KRL Hospital, Islamabad..
Professional Med J Jan ;30(7):906-11.

Objective: To determine feto maternal outcome in patients with cesarean section and comparing outcome following TOLAC and elective repeat cesarean delivery. Study Design: Descriptive, Cross-sectional study. Setting: Department of Obstetrics & Gynecology, Kahuta Research Laboratory (KRL) Hospital, Islamabad. Period: 10th September 2019 to 9th March 2020. Material & Methods: 93 pregnant women of gestational age 37-42 weeks with previous transverse cesarean section were included. Patients with a history of multiple pregnancies, ruptured uterus, placenta previa, polyhydramnios or oligohydramnios, and fetal malpresentation were excluded. In each patient, the labor trial was done; if not possible, then a cesarean section was done on the elective list. Each case was done by the researcher herself in the presence of a consultant gynecologist and the mode of delivery (vaginal/cesarean), was noted. After this fetal outcome i.e. live birth (yes/no), NICU admission (yes/no), and Apgar score >6 at 5 minutes (yes/no) was noted.  Results: Maternal outcomes in a previous cesarean section was found to be a cesarean section in 60 (64.52%) and VBAC in 33 (35.48%), an APGAR score >6 at 5 minutes after VBAC was seen in 100.0% and after elective cesarean delivery in 81.67% of neonates. NICU admission is 0.0% in TOLAC compared to 20.0% with elective repeat LSCS. Live birth after emergency cesarean delivery was seen in 93.33% and 100% after VBAC. Conclusion: This study concluded that the maternal outcome in a previous cesarean section was found to be a cesarean section in 64.52% and VBAC in 35.48% of women and fetomaternal outcome following TOLAC is better.

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