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Research Paper | Obstetrics and Gynecology | India | Volume 11 Issue 11, November 2022 | Rating: 4.8 / 10

Implementation of Trial of Labour (VBAC) for Reduction in Repeat Caesarean Section Rate

Dr. Ashlesha Pawar | Dr. Deepak Bade | Dr. Payal Jadhvar

Abstract: Introduction: Majority of maternity hospitals follow a dictum of once a caesarean section, always a caesarean section, especially in private hospitals in India. This unscientific trend has resulted in increase in repeat caesarean sections. Trial of labour in properly selected cases result in uneventful vaginal delivery, thus reducing the rate of caesarean section and its related complications. Methods: A 12 weeks short term QI project was undertaken to find out the incidence of trial of labour in cases of previous caesarean section and their outcome at tertiary care teaching hospital with state of art labour room and operation theatre facilities. Various reasons for low rate of trial of labour were identified by using fish bone used for root cause analysis. Necessary interventions were undertaken to increase the rate of trial of labour and their outcome was measured. Results: It was observed in baseline analysis that that only 20 percent case of previous caesarean section were given trial of labour. The percentage of women with trial of labour increased to 36 percent after 12 weeks of intervention. The success rate of trial of labour increased from 20 percent to 44 percent. There was no increase in maternal and perinatal morbidity and mortality following implementation of QI project. Conclusion: Judicious case selection and proper monitoring during labour resulted into high success rate of trial of labour without adversely affecting maternal and perinatal outcome. This in turn resulted in reduction of rate of repeat caesarean section and its associated morbidity and mortality.

Keywords: VBAC, previous caesarean

Edition: Volume 11 Issue 11, November 2022,

Pages: 736 - 739