The outcome of prostaglandin induction of labour in women with previous scar : a prospective cross sectional study at tertiary hospital

Abstract

The aim of the study was to compare the success rate of vaginal birth following induction of labour in women with previous caesarean birth in comparison to women without previous caesarean birth. This study also aimed to identify the factors associated with successful induction of labour. This is a one year prospective cross sectional study carried out in Hospital Tengku Ampuan Afzan (HTAA) in Kuantan, Pahang. A Ttotal of 100 women with a term singleton pregnancy who had one previous low transverse caesarean section presenting to HTAA for induction of labour with prostaglandin E2 (PGE2) were compared with a control of 100 women with intact uterus. Primary outcome measured was the rate of successful vaginal delivery. Others include maternal and neonatal complications, and factors associated with high likelihood of vaginal delivery. Rate of vaginal delivery in women with scarred uterus was only 29% compared to control group (78%) which is statistically significant (p<0.001). There were no cases of uterine rupture or primary postpartum hemorrhage. All babies were born with good Apgar score (7 and more at 1 and 5 min). Only 29% of women with scarred uterus who were induced with PGE2 have successful vaginal delivery. Those with previous vaginal birth and high Bishop score (BS) have better chance for successful vaginal birth after caesarean (VBAC). PGE2 induction does not increased risk of maternal and fetal morbidity.