Evaluating Successful Pregnancy Outcome in Women Undergoing Trial of Labour after Caesarean Section (TOLAC)

Abstract

Objective: To determine the successful pregnancy outcome in women who opted for trial of labour after one lower segment transverse caesarean section (TOLAC). Study Design and Setting: Descriptive cross-sectional study. Department of Obstetrics and Gynaecology, Combined Military Hospital Abbottabad, from Nov 2022 to April 2023. Methodology: 54 pregnant women were included in our study who had previously undergone one lower segment caesarean section more than 18 months back. They were booked at their first visit, briefed and counselled for trial of labour after caesarean section (TOLAC ), and were advised to await spontaneous labour till 40 completed weeks of gestation and in case of failure of onset of labour then for induction of labour. Data was collected in terms of successful vaginal birth/repeat caesarean section and fetomaternal outcome. Results: In our study, 54 women agreed for trial of labour who had one caesarean section more than 18 months back. Vaginal birth was successful in 39 women (72.22%). Gestational age, BMI, and age of the woman did not show any significant effect on trial of labour. Factors leading to successful outcome include previous vaginal delivery, spontaneous onset of labour, favourable bishop score, women who are keen for vaginal delivery. Conclusion: The study concluded that most pregnant women prefer labour trial after one CS. Adequate counselling and briefing of women reduce their anxiety, and help them to make decisions about their preferred mode of delivery