Assessment of outcome of Trial of Labour after caesarean in a tertiary hospital based setting : Prospective Observational Study

Objective: To determine the success rate of vaginal birth after caesarean (VBAC) in Indian women, identify the factors that predict its success, and assess the maternal and neonatal outcomes following a trial of labour after caesarean (TOLAC). Design: Prospective observational study Setting: Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India Sample: 124 women with previous LSCS who opted for TOLAC Methods: A prospective observational study involving women with one previous lower segment caesarean section (LSCS) who were admitted for TOLAC between January 2019 and June 2020. Main outcome measures and Results: During the study period, 124 women with previous LSCS who opted for TOLAC were included, of whom 68 (54.8%) had successful VBAC and 56 (45.2%) had failed TOLAC. The induction of labour (IOL) rate in the study was 69.4%, and 30.6% of women had spontaneous onset of labor. VBAC rates were significantly higher in women who went into labour spontaneously (84.2% vs. 15.8%). Maternal complication rates were comparable, whereas the neonatal complication rate was significantly higher in neonates born by CS (51.7% vs. 30.8%), with a greater incidence of low birthweight (LBW) and transient tachypnea in the newborn (TTNB). Conclusions: TOLAC can be considered a safe option for women with a previous caesarean when combined with vigilant and stringent labour monitoring, despite the use of IOL agents. Funding : Not applicable.