Abstract:
Objective: To determine obstetric outcome among women with one previous caesarean
section (CS).
Methodology: A hospital based cross sectional descriptive study was conducted
frOml3th September 2006 to 2"d February 2007 at Muhimbili National Hospital, Dar-es-
salaam, Tanzania. All women with one previous CS coming for delivery were identified
on admission. Data on demographic, obstetric, social and medical history, the outcome of
the index pregnancy and the indication for the previous CS were collected. The maternal
and perinatal outcomes of patient who underwent trial of scar (TOS), elective repeat CS
(ERCS) and emergence repeat CS (EmRCS) were analysed.
Main results: There were 3,285 deliveries conducted during the study period of which
365 (ll .I%) had one previous CS. TOS was done in 80 (22.3%) women of which
41(51.2%) had successful TOS. Dystocia accounted for 63% of the failed TOS and was
the main indication for repeat CS (43.5%). It also contributed to 62.6% of the indication
for the first CS. There was no much difference in foetal outcome between women
underwent TOS and those repeat CS was done. ERCS resulted in better APGAR score
than ERCS. There were seven ruptured uterus all in EmRCS. The mean decision time for
failed TOS to delivery was 3 hours and the mean duration of labour was 9 hours.
Conclusion: The proportion of women undergoing TOS is small. The success rate in
TOS is more than 50%~ There was no much difference in morbidity between women
underwent TOS and those repeat CS was done. Doctors should be encouraged to offer
TOS to pregnant women with one previous caesarean section.
