FIND THE FREQUENCY OF UTERINE RUPTURE IN VAGINAL BIRTH AFTER CESAREAN SECTION (VBAC) AND COMPARE RATES BETWEEN SHORT AND LONG INTERPREGNANCY INTERVALS

Abstract

Vaginal births after cesarean (VBAC) is not typical and uterine rupture, the most serious complication of a TOL after Cesarean, is characterized as the complete separation of the myometrium regardless of extrusion of the fetal parts into the maternal peritoneal cavity. Objective: To determine the frequency of uterine rupture in women who attempt vaginal birth after cesarean section and to compare the frequency of uterine rupture in women with short and long inter-pregnancy intervals. Methods: This Descriptive Case Series was conducted from December 23, 2015, to June 22, 2016.  Ninety (90) patients were recruited based on inclusion/exclusion criteria. Women were then divided into two groups in short and long interpregnancy intervals per the operational definition. The outcome variable, i.e., uterine rupture, was noted as per the operational definition during the delivery. Results: A total of 90 women were included in this study. The age of the women ranged from 18-40 years. The average age of the women was 28.49 + 4.49, with a mean gestational age of 36.45 + 2.24, mean height of 161.94 + 7.62, mean weight of 67.73 + 11.9, and mean BMI of 25.7 + 4.05. The mean inter-pregnancy interval in women who attempted VBAC was 34.8 + 9.73. 70(78%) had 2-4 parity and 20(22%) had parity >4. 58(64.4%) had long inter pregnancy interval and 32(35.6%) had short pregnancy interval. (Table no: 11) Conclusion: The data indicate that the relative risk of uterine rupture is increased in women undergoing a TOL after Caesarean. Short pregnancy interval increases the risk for uterine rupture two-fold to three-fold in VBAC Women.