Frequency of failed trial of labour and its morbidity in patients with previous one caesarean birth

Background: increasing rates of primary caesarean section have led to an increase in the proportion of obstetric population who has prior caesarean delivery. these women may be offered planned trial of labor or elective repeat caesarean section in a subsequent pregnancy and majority of them may have an uncomplicated vaginal delivery. aim: to determine frequency of patients who failed trial of labor after one lscs and maternal morbidity as a result of it,in a tertiary care hospital. methods: this descriptive case series comprised 275 patients was conducted in the department of gynaecology &obstetrics,unit-i,services hospital,lahore over a period of six months from 15-05-2012 to 14-11-2012. labor was monitored vigilantly. emergency lscs was planned immediately in case of arrest of labor,any symptomatic uterine dehiscence/rupture or any onset of distress to the fetus. these patients were noted for uterine dehiscence/rupture found as an intra-operative finding. results: in our study the mean age of the patients was 28.2±3.4 years. in the distribution of patients by complications,14(5.1%) patients had scar dehiscence/rupture,50(18.2%) patients had postpartum haemorrhage and 16(5.8%) patients had endometritis. there were 1(0.4%) patients had hysterectomy and 12(3.6%) patients had blood transfusion >1 unit. conclusion: it is concluded from this study that failed trial of labor in women at term with prior cesarean is associated with increased maternal complications such as uterine dehiscence/rupture,pph,endometeritis,hysterectomy and blood transfusions.