EMERGENCY REPEAT CESAREAN SECTION IN WOMEN IN MALALAI AND SHARARA HOSPITALS

Abstract

Repeat cesarean deliveries are associated with complications of cesarean section (CS) and predisposition to morbidity resulting from placenta previa, morbidly adherent placenta, complicated surgeries, uterine rupture and bladder injury. Successful trial of labor and vaginal birth after cesarean section (VBAC) results in decrease in maternal morbidity. An unsuccessful trial of labor after Cesarean (TOLAC) is defined as failure to achieve a vaginal birth after cesarean section in women undergoing a TOLAC and the delivery ending with emergency cesarean section. In this study we aim to determine the frequency of inter delivery interval and emergency cesarean section attempt at vaginal delivery among women with one previous CS. The descriptive cross-sectional study was conducted at Malalai and Sharara maternity hospitals in Kabul, for three consecutive months. The collected data were presented as mean, standard deviation (±SD),frequency and percentage.A total of 204 women with one previous CS out of 180 were eligible for TOLAC according to the hospital protocol and 35 women (19.4%) of the studied women had emergency cesarean, 34.47% women with their inter delivery interval were between 16-19 months most cases of unsuccessful TOLAC 43% were seen among women between 25 to 29 y old with mean age of 26.43 ± 5.6. In our study frequency of repeat emergency cesarean in women with prior CS was found as 19.4%, most cases have been seen in women with short inter delivery interval, most cesarean performed between 37-39 week of gestational age, fetal distress was the most indication of repeat emergency cesareans.