Outcome of trial of labour after one previous cesarean section at Federal Medical Centre, Bida, north central, Nigeria.

Objective: To determine the success rate and feto-maternal outcomes following trial of labor among women with one previous cesarean section (C/S) seen at the Federal Medical Centre, Bida, Nigeria.

Material and methods: This was a prospective cohort study among selected women with a previous C/S admitted for trial of labor after C/S over a 15 month period. Demographic and medical history data was collected by questionnaire. Women achieving vaginal birth after cesarean (VBAC) and those undergoing emergency repeat C/S (ERCS) were compared statistically for differences and associations based on a range of variables.

Results: A total of 150 women with one previous C/S were included. Out of 150 study participants, 105 (70.0%) achieved VBAC while 45 (30.0%) had ERCS. Women with previous vaginal delivery had higher odds of achieving VBAC. Poor progress of labor was the most common indication for ERCS (17/45; 37.8%). The most frequent maternal complication following abdominal delivery was post-partum hemorrhage (n=15; 33.3%) while perineal laceration (n=26;24.8%) was the commonest among women who achieved VBAC. The ERCS cohort suffered significantly more complications in comparison to those who had VBAC. Comparison of fetal outcomes by mode of delivery were comparable, except that neonates admitted into special care baby unit were more likely to have been born via ERCS (odds ratio 5.231; 95% confidence interval 1.247-21.950) compared to those born via VBAC. There was no perinatal or maternal mortality. However, one case of ruptured uterus was recorded.

Conclusion: These results demonstrated that good outcome following trial of labour is achievable among well selected women, even in low resource settings.