Navigating Trial of Labor after Cesarean Section: Insight into Unfavorable Results

Umairah yaqub; Ayesha  Imran; Viqar Ashraf; Asifa  Siraj; Qurat ul Ain  Aslam; Mahpara Tariq

doi:10.51253/pafmj.v76i1.12841

Authors

Umairah yaqub Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ayesha Imran Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Viqar Ashraf Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Asifa Siraj Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Qurat ul Ain Aslam Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Mahpara Tariq Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i1.12841

Keywords:

Bishop Score, Cesarean Section, Hemorrhage, Laparotomy, Trial of Labor After Cesarean Section (TOLAC), Uterine Rupture

Abstract

Objective: To measure the frequency of unfavorable maternal and fetal outcomes in patients who have failed trial of labor after cesarean section (TOLAC) and to compare them to demographic factors and clinical parameters to establish significance.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Gynecology and Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Feb to Dec 2024.

Methodology: After ethical approval, we presented our experience regarding unfavorable outcomes of trial of labor after cesarean section (TOLAC) with demographic characteristics and clinical parameters in Pakistani population. The aim of the study was to help obstetricians to identify the negative indicators of TOLAC to minimize maternal morbidity and improve the success rate.

Results: The frequency of unfavorable maternal and fetal outcomes was higher in Group B patients. The frequency of peri-partum Hemorrhage was 7(14.3%) in Group A patients and 8(38.1%) in Group B patients, frequency of chorioamnionitis was 2(4.1%) in Group A patients versus 5(23.8%) in Group B patients and the frequency of uterine rupture was 1(4.8%) in Group B patients and none in Group A patient.

Conclusion: We concluded that unfavorable maternal and fetal outcomes of trial of labor after cesarean section are linked to maternal demographics (weight, patient enthusiasm, booking status) and clinical parameters (Bishop score, cervical dilatation, and effacement) at time of admission and they were found more frequently in patients with failed TOLAC.

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