outcome of antenatal CARE PLANNED VBAC versus unplanned VBAC

Abstract

Abstract Background: The primary target when setting policies in obstetrics and gynaecology is gaining successful delivery with the minimum feto-maternal adverse outcome. Studying the difference between planned and unplanned vaginal birth after caesarean section expected to serve such goal by monitoring and evaluating the possible risks in unplanned VBAC such as risk of rupture uterus and other relevant complication. Materials: all pregnant women with one previous caesarean section planned for VBAC either in the ANC or labour pain. Results: A total of 245pregnant women had been enrolled in this study. The age of both groups found to be similar to each other. the education level had significant effect on the type of delivery in group A the majority of the women was university graduate while in group B who were unplanned for VBAC the majority are secondary. Most of both groups are from urban area. In group A, most of the patient parity are vary between I-IV as follow (87.6%) while in group B I_IV (84.6%). Group A had high visit rate for ANC most of them went to referral clinic (51.1%). While in group B (68.9%) went to health center. The commonest indication for a previous CS was failure to progress in both groups. The success rate of VBAC in both groups was similar (68%) in group A while in group B (67%). the commonest type of previous C/S was emergencies in both groups. In group A (94%) had been counseled for VBAC and majority was counseled by registrar while the majority in group B had not been counseled for VBAC.The maternal outcome in group A was (1.4%) for PPH & (1.4%) for uterine rupture while in group B (1%) for PPH and (2.9%) for uterine rupture and the majority of both groups had no complication. The neonatal outcome in group planned for VBAC was good (99%) alive baby while in group B (7%) had FSB. Group B recorded much rate admitted to ICU (18%). Conclusion: The study highlighted that the success rates of VBAC in planned group were significantly higher than the unplanned group. There was no significant different in the maternal morbidity, the neonatal outcome in group planned for VBAC was better than in group B. Group B recorded much rate admitted to NICU among them the birth asphyxia was high than group planned for VBAC.