A STUDY OF PREGNANCY OUTCOME IN PREVIOUS CESAREAN SECTION

Background: The global increase in cesarean section (CS) rates has raised concerns about associated maternal and fetal risks, particularly in pregnancies following a previous CS. This study evaluates the outcomes of pregnancies in women with a history of one prior CS, focusing on demographic factors, indications for primary CS, and maternal and neonatal complications. Materials And Methods: This observational study was conducted in the Department of Obstetrics and Gynaecology, Shrimati Heera Kunwar Baa Mahila Hospital, affiliated with Jhalawar Medical College, Rajasthan, from February 2022 to January 2023. A total of 200 pregnant women with a history of one prior CS and beyond 37 weeks of gestation were included. Data on demographic characteristics, primary CS indications, intraoperative complications, and maternal and neonatal outcomes were collected and analyzed using SPSS 20.0. Statistical significance was set at p<0.05. Results: Among 4423 deliveries during the study period, 1940 were CS, with 559 due to a previous CS. Significant differences were noted between repeat CS (RS) and vaginal birth groups in indications like failed induction (29.16% vs. 21.02%, p<0.05), fetal distress (20.83% vs. 17.05%, p<0.05), and CPD (14.20% in RS group only, p<0.05). Adhesions (28.41%) and significant blood loss (11.93%) were the most common intraoperative complications. Neonatal outcomes were favorable, with 95% shifted to the mother's side. Wound complications were significantly higher in the RS group (11.36%, p<0.05). Conclusion: Pregnancy outcomes after a previous CS depend on careful patient selection and risk assessment. While VBAC is a viable option for reducing CS rates, it requires thorough evaluation and proper clinical management to ensure safety.