Review of lower segment caesarean section scar dehiscence (partial uterine rupture) occurring among women undergoing trial of labour after caesarean at sarawak general hospital, malaysia in 2010

Objective: To study the incidence of lower segment caesarean section scar dehiscence (partial rupture) among women who had trial of labour after one previous lower segment caesarean section and its associating factors at Sarawak General Hospital, Malaysia, 2010
Design: A hospital based retrospective study.
Setting: Maternity Unit, Sarawak General Hospital, Malaysia.
Population: Total of 525 pregnant women with one previous lower segment caesarean section scar for trial of vaginal delivery at Sarawak General Hospital in 2010.
Methods: This study was carried out in Sarawak General Hospital through the antenatal, intrapartum and postnatal records.
Results: A total of 525 pregnant women with one previous lower segment caesarean section scar had a trial of vaginal birth. Among the 525 women, 390 did not have a prior history of successful VBAC and the remaining 135 women had at least one successful VBAC. Among 390 pregnant women, 208 (53.3%) had successful vaginal deliveries and 182 (46.7%) women underwent emergency lower segment caesarean section as failed VBAC. Among the 182 women, there were two cases of scar dehiscence and both had emergency LSCS performed for abnormal foetal heart tracing. Both had good foetal outcome.
Conclusion: Incidence of lower segment caesarean section scar dehiscence is more common than uterine scar rupture in TOLAC and abnormal changes in foetal heart tracing is an early indicator of impending rupture.