Objective: Our study was to evaluate mode of delivery, foetal and maternal morbidity and mortality in post caesarean section pregnancy and compared the maternal and foetal outcome between caesarean section delivery and vaginal delivery.

Methodology: A total of 100 cases of pregnant women with 28 weeks of gestation with or without previous history of single or multiple caesarean section delivery were enrolled. A detail relevant obstetric history, socio economic status, general examination, haemoglobin percentage, maternal condition, foetal conditions were assessed. Progress of labour was monitored minutely during trial of labour. Maternal pulse, BP, uterine activity, scar tenderness and foetal heart sound were recorded every ½ an hour, during 1^st stage of labour. The progress of labour was assessed by dilatation of Cervix, and descent of presenting part at an interval of 3 hours. Elective caesarean section was done to those cases where patients were not allowed for labour or contraindicated for vaginal delivery. Condition of baby was assessed by apgar score at 1 min. and 5 minutes.

Results: Data was analyzed by using simple statistical methods with the help of MS-Office software.

Conclusions: Our study was to conclude that the majority of cases were undergone to caesarean section delivery. Commonest cause of caesarean section was cephalopelvic disproportion. Vaginal delivery was more common in cases with low socioeconomic status. Incidence of vaginal delivery was more in condition of pregnancy induced hypertension and babies with high birth weight, majority of cases were delivered by use of forecep.

Keywords: caesarean section, vaginal delivery, clinical outcome.

1. P. Souza, A.M. Gülmezoglu, P. Lumbiganon, M. Laopaiboon, G. Carroli, B. Fawole, P. Ruyan, BMC Medicine, 2010,8,71.
2. World Health Organization, WHO/RHR/ HRP/10.20, 2010.
3. P. Sachs, M.A. Castro, N Engl J Med., 2003,340,54.
4. K. Stanton, S.A. Holtz, Studies in Family Planning, 2006, 37, 41.
5. Bergholt, J. K. Stenderup, A. Vedsted-Jakobsen, P. Helm, and C. Lenstrup, “Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors,” Acta Obstetricia et Gynecologica Scandinavica, 2003; 82(3): pp. 251–256.
6. Fawzy and K. Zalata, “Late post-cesarean surgical complication,” Journal of Obstetrics and Gynaecology Research, 2010; 36(3): pp. 544–549.
7. Gibbons, J. M. Belizan, J. A. Lauer, A. P. Betran, M.Merialdi, and F. Althabe, “Inequities in the use of cesarean section deliveries in the world,” American Journal of Obstetrics and Gynecology, 2012; 206(4):pp. 331.e1–331.e19.
8. World Health Organization. WHO Recommended Interventions for Improving Maternal and Newborn Health. WHO/MPS/07.05. Geneva: WHO; 2007.
9. World Health Organization. Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice. Geneva: WHO; 2006.
10. World Health Organization, UNFPA, UNICEF and AMDD. Monitoring Emergency Obstetric Care: a Handbook. Geneva: WHO; 2009.
11. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 2006;367(9525):1819–29.
12. Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ 2007;335(7628):1025.
13. Henderson J, McCandlish R, Kumiega L, Petrou S. Systematic review of economic aspects of alternative modes of delivery. BJOG 2001;108(2):149–57.
14. Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS (2013) Advanced Maternal Age and Adverse P
    regnancy Outcome: Evidence from a Large Contemporary Cohort. PLoS ONE. 2013; 8(2): e56583.
15. Sheuly Begum , Ferdousi Islam , Arifa Akter Jahan. Feto-maternal Outcomes in Cesarean Section Compared to Vaginal Delivery in Eclamptic Patients in a Tertiary Level Hospital. Journal of Enam Medical College, 2013;3:2.
16. Shah A, et al, Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa, Int J Gynecol Obstet (2009), doi:10.1016/j.ijgo.2009.08.013.
17. Petrie R, Richart R, Strassar J, Cohen W. Is caesarean section cost effective ? Contempt Obstet Gynaecol 1982 ; 19 : 161.
18. Shy L, Logerfo J, Karp L. Evaluation of elective repeat caesarean section as a standard of care. Am J Obstet Gynecol 1981 ; 139 : 123.
19. Gonen R, Nisenblat V, Barak S, Tamir A, Ohel G. Results of a well defined protocol for a trial of labour after prior caesarean section. Obstet Gynecol 2006; 107:240-5.
20. Graham A. Trial of labour following previous caesarean section. Am J Obstet Gynecol 1984 ; 149 : 35.
21. Kala S, Alam M. Post Caesarean Pregnancy - A Study. J Obstet Gynaecol India 1983 ; 36: 797.
22. American College of Obsetricians and Gynecologists Committee on Obstetric Practice Bulletins. ACOG Practice Bulletin No. 54: Vaginal birth after previous caesarean delivery. Obstet Gynecol 2004; 104: 203-12.
23. RCOG Green top guideline No. 45. Birth after previous caesarean birth. Feb 2007.
24. American College of Obsetricians and Gynecologists Committee on Obstetric Practice Bulletins. ACOG Practice Bulletin No. 54: Vaginal birth after previous caesarean delivery. Obstet Gynecol, 2004 ; 104 : 203-12.

Dr Chhavi Raman Baid

Assistant Professor, Department of Obstetrics and Gynaecology, Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India

Contact: +91 8789430115. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.