University of Khartoum

Vaginal Birth after Caesarean Section

Vaginal Birth after Caesarean Section

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Title: Vaginal Birth after Caesarean Section
Author: Kariom , Makur Matur
Abstract: Background: Globally, Caesarean section (CS) rates have been on the increase despite the World Health Organisation (WHO) assertion that rates exceeding 15% are unjustifiably high. This concern is reinforced by the risks posed by CS, slow maternal recovery and the inflated costs against limited resources, especially in low-resource countries including Sudan. This study examines the feasibility of trial of labour in relatively under-resourced settings, in a woman who has had caesarean birth in previous pregnancy. Objectives: To evaluate the effectiveness and safety of trial of labour in patients with previous CS; to evaluate the maternal and perinatal morbidity and mortality associated with the VBAC, and to assess the maternal satisfaction following a successful VBAC. Materials and Methods: A prospective multicentre study involving 101 women who have had lower segment CS in the past, and are contemplating VBAC was conducted at Soba University Hospital (SUH), Omdurman Maternity Hospital (OMH) and Al Saudi Maternity Hospital (AMH) which are among the largest referral maternity hospitals in the Sudan. The study was conducted from November 1999 to May 2000. A quantitative method of data collection was used to collect data using a special questionnaire specifically designed for this study. Results: The overall success rate for VBAC was 85.1%. The success rate at SUH was 87%, OMH 90.7% and AMH 70.8%. The overall failure rate was 14.9% with the corresponding failure rates being 13%, 9.3% and 29.2% respectively. Conclusions and Recommendations: VBAC is safe and should be offered to all women with no contraindication to vaginal delivery. Women contemplating VBAC may be allowed to do so provided that appropriate counseling to inform their choice has been offered. Careful review, evaluation and documentation of previous obstetric records and the current pregnancy is paramount. Although the sample size was relatively small, the feasibility and safety of VBAC in Sudanese setting cannot be overlooked and should be recommended where essential requirements for emergency obstetric care are available
Description: 75 Pages
URI: http://khartoumspace.uofk.edu/handle/123456789/8971
Date: 2015-04-14


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