3. Results
sepsis, oligohydramnios without premature rupture, prelabour
SCAR, FAILED INDUCTION, DEHISCENCE, GESTATIONAL HYPERTENSION, SEPSIS, BREECH PRESENTATION, COMPLICATIONS, POSTPARTUM HAEMORRHAGE
We screened 1886 women; 966 were otherwise low-risk and could undergo expectant management. 35% of these were either unwilling for TOLAC or the study. Sixty women fulfilled the inclusion criteria (
There was a significantly higher VBAC rate in the induction group. Twenty of the 30 (66.67%) women in the induction group had a successful vaginal birth. Sixteen had a vaginal delivery, and four had an instrumental vaginal delivery (vacuum-assisted delivery). For varied indications, the remaining ten subjects (33.33%) underwent caesarean section after the onset of labour. The expectant group had a VBAC rate of 33.33%, with only 10 out of the 30 women undergoing successful vaginal delivery, and this difference was significant (RR 2.0, 95% CI: 1.13-3.52; In the expectant group, out of the 30 women, thirteen (43.33%) went into spontaneous labour before 41 weeks (seven of them had VBAC (54%)), 7 underwent induction before 41 weeks for different complications (one developed gestational hypertension, five had oligohydramnios without premature rupture of membranes, and one had reduced foetal movements), and nine underwent induction at 41 weeks as per protocol. One had a prelabour CS for the spontaneous conversion to breech presentation (One case of scar dehiscence in the expectant arm was confirmed intraoperatively. This woman did not go into spontaneous labour during the expectant management period. She underwent labour induction at 41 weeks as per protocol. She underwent an emergency caesarean for failed induction. However, intraoperatively, a 3 cm scar dehiscence was observed. We repaired the rent, and the woman recovered uneventfully. There were no cases of scar dehiscence in the induction at 40 weeks arm. There was no third or fourth degree perineal tear in women with spontaneous or operative vaginal delivery.None of the women developed any complications like sepsis or postpartum haemorrhage. None of them required a blood transfusion or hysterectomy.There were no stillbirths. None of the babies were born with a low Apgar score. None of the neonates required admission to an intensive care unit. There was no morbidity or mortality among these sixty newborns. We could not assess the perinatal and maternal outcomes as our study did not have the power for it. We recommend future trials powered for these outcomes.