Trial of Labour after Caesarean Section in a Secondary Health Facility in Abakaliki, Nigeria

Abstract

Background: The mode of delivery of a parturient is influenced by previous caesarean section (CS) scar.

Objective: The objective of the study is to evaluate the pregnancy outcomes of a parturient with one previous caesarean delivery that was managed in Mile Four hospital, Abakaliki, Nigeria.

Materials and Methods: A 5‑year retrospective study of women with one previous CS who delivered in Mile Four hospital between January 2011 and December 2015 was done. IBM SPSS version 20 was used for data analysis, and data were represented using frequency tables, charts, and Chi‑square. The level of significance was set at an alpha level of 0.05.

Results: Three hundred and twenty‑two (322) women with one previous CS were selected for a trial of labor after A C/S (TOLAC). More than half of the women (53.1%) had successful TOLAC while 46.9% had a repeat CS. Of the 53.1% of women who had a successful TOLAC, One hundred and forty-one patients had spontaneous vertex delivery. Seventeen women (9.9%) on the TOLAC arm had a ruptured uterus, while seven patients (4.6%) failed the TOLAC group had uterine dehiscence. Haemorrhage was the most common maternal complication. Severe asphyxia and perinatal death were present in 5.9% and 5.3% of neonates on TOLAC arm, respectively.

Conclusion: Trial of labour after a CS can result in an excellent outcome in a well‑selected patient. The success rate of 53.1% in our study is encouraging. However, adequate intrapartum monitoring is recommended to reduce maternal and fetal complications.