Outcome of Subsequent Labour After Primary Caesarean Section For Arrest Disorders in Teenage Pregnancies
AbstractContext: Teenage mothers are at risk of numerous problems among which is cephalopeelvic disproportion or obstructed labour because of small and immature pelvis. This leads to a tendency to allowing trial of scar in subsequent pregnancies because the teenage pelvis might not have reached full capacity as at the time of the previous caesarean section. Despite the fact that some of the patients had a height of more than 152cm. Complications of scar dehiscence, haemorrhage, sepsis etc., and perinatal morbidity / therefore imperative to examine the outcome of labour in teenage mothers with one lower uterine segment caesarean section scar in which the section was done because of obstructed labour or CPD.
Objective: To determine the outcome of trial of labour after one previous lower uterine segment transverse caesarean section. The main focus is possibility of vaginal delivery and associated morbidity mortality and mortality.
Design: A longitudinal study (1993-1999).
Participants And Methods: Teenage mothers with one previous lower transverse uterine segment caesarean section scar which was performed 2-3 Years earlier were allowed to labour. All these caesarean sections were primarily done because of cephalopelvic disproportion with or without obstructed labour.(excluded were those with more than 3 Years- as these were already over 19 Years). Setting: University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Main Outcome Measures: The possibility of vaginal delivery, the fetal outcome and associated morbidity and mortality.
Results: 66 women were eligible for the study. 67% successfully achieved vaginal delivery. There was no maternal mortality even though there were 2 cases of ruptured uterus.
Conclusion: Mothers aged 19 years and under with one previous transvere lower uterine segment caesarean section scar performed for cephalopelvic disproportion or obstructed labour should be allowed to labour with the aim of achieving vaginal delivery. This was found to be very possible and of benefit in this study.
[Trop J Obstet Gynaecol, 2004;21:36-39]
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