A Retrospective Study of Trial of Labour After Caesarean Section (TOLAC)
Vandita Kailas Patil, Usha Varghese
Published: October 01, 2021.
Abstract
Abstract
Objective: To determine how best to manage subsequent deliveries after one lower segment caesarean section and to examine the advantages and disadvantages involved in trial of labour after caesarean section.
Method: Retrospective study of Trial of Labour After Caesarean Section was conducted in Buraimi regional hospital under ministry of health, Sultanate of Oman from 1st January 2018 till 31st December 2018.
Results: There were total 278 patients who opted for TOLAC. Successful vaginal birth after caesarean (VBAC) was in 145 patients (52.1%) Out of 145 VBAC, 73.1% (106) patients were <35 years of age. 121 patients (83.4%) were < 41 weeks of pregnancy. 108 patients (74.4%) were with history of previous vaginal delivery. 94 patients (64.8 %) were with last childbirth > 2years. 84.1% (122) patients were with BMI (Body mass Index) of <30. Out of 145 VBAC, 136 (93.7%) patients were in spontaneous labour & 92 (63.4%) patients Bishop’s score was >5 cm at admission. Failure of TOLAC resulting in emergency repeat caesarean delivery was for 133 patients (47.8 %). Out of 133 failed TOLAC, 29 patients (21.8%) were > 35 years of age. 5.2% (7) patients had induction of labour. Bishop’s score of majority of the patients 116 (87.2%) was < 5 cm & 58 patients (43.6%) received augmentation of labour. Non recurrent indications of caesarean section were seen in 101 patients (75.9%). No complications like uterine rupture, fetal demise etc. reported in the 278 women who opted for TOLAC.
Conclusion: TOLAC is a potential strategy for decreasing caesarean section rate if proper selection criteria are adopted.
Keywords: Trial of Labour After Caesarean Section (TOLAC); Lower uterine Caesarean Section (LSCS); Elective Repeat Caesarean Delivery (ERCD); Vaginal Birth After Caesarean Section (VBAC); BMI (Body mass Index)