RISK OF UTERINE RUPTURE WITH VAGINAL BIRTH AFTER C-SECTION

Background: The procedure of vaginal birth following cesarean delivery (VBAC) now emerges as a significant alternative to women who have undergone cesarean delivery previously, but still, rupture of the uterus is a severe complication that comes with the attempt to deliver a baby by labor. Objective: To identify the risk of uterine rupture in women who deliver vaginally following cesarean section and compare the results with those of women delivering through repeat cesarean section. Methods: The present case-control study was carried out at the Department of Obstetrics and Gynecology at Liaquat National Hospital, Karachi, Pakistan, between November 2024 and April 2025. Eighty-eight women who had a history of a previous cesarean section were used. The participants were categorized into two groups: 44 women undergoing vaginal birth with cesarean (VBAC) and 44 women undergoing repeat cesarean section. The information on maternal characteristics and obstetric history, along with complications such as uterine rupture, was collected and analyzed with the help of SPSS version 25. Results: The average maternal age of the respondents was 29.8 years with a standard deviation of 4.2. There was also a case of uterine rupture in 3 women (6.8 respect of 20) in the VBAC group, and no such cases were found in the repeat cesarean section group. The majority of women who had tried VBAC delivered without any significant complications. The most prevalent maternal complications were emergency cesarean section and postpartum hemorrhage. Conclusion: VBAC might be a safe solution in the case of selected women who have had prior cesarean delivery, but the threat of uterine rupture still exists. The right labor monitoring, patient selection, and emergency obstetric services will help to improve the maternal and neonatal outcomes.