Predictors of Successful Vaginal Deliveries after Previous one Caesarean

Objective: to compare the outcomes in patients undergoing TOLAC after one LSCS and find out successful predictors for vaginal delivery in those who have delivered vaginally in comparison to those who end up in repeat C-section. Study Design: Prospective comparative study. Place and Duration of Study: Department of Gynecology and Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2023 to June 2024. Methodology: Three hundred women of reproductive age group with previous single caesarean deliveries were included in the study. The demographics, obstetric history, index pregnancies, and medical details of each case were examined. Induction of labour, BISHOP score upon admission, BMI, gestational age at delivery, estimated foetal weight, intrapartum features, mode of delivery, previous vaginal delivery and intraoperative observations were all noted. Results: A total three hundred (n=300) patients were included 150(50.0%) of the cases resulted in a successful vaginal delivery, whereas 150(50.0%) underwent repeat caesarean delivery. The overall success rate of VBAC after exclusion of caesarean cases due to maternal requests was 73.0%. Methods of labour inductions were as follows: balloon (n=20), oxytocin (n=64), balloon followed by oxytocin (n=18), vaginal PGE2 (n=2), balloon followed by vaginal PGE2 (n=4), c-section followed by relaparotomy due to intrapelvic hematoma (n=1), dehiscence (n=7). Multiple regression analysis showed BISHOP score at admission were statistically significant difference (p-value=0.001; 95% Cl= 0.023 – 0.095). Women with a BMI of less than 28 had a two times of giving ..... Conclusion: The BISHOP score upon admission, TOLAC score, body mass index, number of prior.....