TRIAL OF LABOR

Objective: To determine the frequency and types of vaginal delivery in womenwith previous one caesarean section and to observe the effect of women age on success ofvaginal birth. Method: A descriptive study was carried out in the department of obstetrics& gynecology, Ziauddin University Hospital Kemari campus Karachi from January 2011 toJanuary 2013. 200 patients with previous one caesarean section for a non recurrent cause wereincluded in the study after fulfilling the inclusion and exclusion criteria. The women selectedwere evaluated and counseled for trial of labor. The frequency and mode of vaginal delivery wasrecorded in cases of successful trial of labor and caesarean section was performed in case offailed trial of labor. Results: Successful vaginal delivery was achieved in 67% of the patients andrepeat emergency caesarean section was carried out in 33% of the patients. Leading indicationfor repeat caesarean section was failure to progress, fetal distress and scar tenderness. Nomaternal and fetal complication occurred. We also observed that patients of less than 30 yearswere more likely to have a successful vaginal delivery (82%) as compared to patients older than30 years (18%). Conclusions: The trial of labor should be encouraged with vigilant monitoringin patients with previous one Caesarean section and is a safe and successful option if carefullyselected and monitored.