Outcome of Mechanical Induction of Labour in Patients with Previous One Caesarean Section
Backgound:To determine the role of mechanical induction with cervical Foley's in reducing the rate of repeat caesarean section.
Methods: In this observational study women who had previous one LSCS with vertex presentation, gestational age b/w 37-40 weeks, previous caesarean to delivery interval >18 months and bishop score >5 were included.Women not consenting for mechanical Induction of labour, medical disorders like diabetes, hypertension, preterm and postdates pregnancy, multiple pregnancy, intra uterine growth retardation (IUGR) and who had an absolute indication for repeat caesarean section were excluded. Eighty patients who fulfilled the inclusion criteria and had properly defined indication for TOLAC were included in the study. After assessment of Bishop Score, they were induced with cervical foley’s. The primary outcome measure was Vaginal Birth After Caesarean-section (VBAC), secondary outcomes were induction to delivery interval, maternal and fetal complications, indications for LSCS, NICU admission and patient’s satisfaction.
Results :A total of eighty patients were induced with cervical foley’s. Out of these patients, the successful VBAC was observed in 58 (72.5%). Among them spontaneous VBAC in 55 ( 68.8%) patients and ventouse delivery in 3( 3.8%). Emergency LSCS for different indications in 22 (27.5%), mean induction to delivery interval was 8.75 hours, Scar rupture was reported in only one ( 1.25%) , 5 (6.3% ) newborn babies were admitted in NICU,6( 7.5%) had PPH. Majority (95% ) were found satisfied.
Conclusion: Mechanical induction with cervical Foley’s in patients with previous one cesarean section is a reasonable option to reduce the rate of repeat LSCS, provided there is careful selection of the cases antenatally and vigilant intrapartum monitoring.