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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What are the chances of normal delivery after undergoing a caesarian delivery?

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Dr. Sameer Kumar

OBGYN

Practicing since :2002

Answered : 1656 Questions

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Posted on Wed, 31 Oct 2018 in Pregnancy
Question: Hi doc, my expected date of delivery is today 20th. I have recently done a sonography and am attaching the results. My first baby was a via a scissor, however wanted this one to be normal if possible. However I do not want prolong the delivery from hereon and wanted to decide based the chances I have for a normal delivery. Can you please advise me looking at the reports.
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Answered by Dr. Sameer Kumar 31 minutes later
Brief Answer:

Please attach report and mention age of your first child.

Detailed Answer:

Hello,

Firstly, the ultrasound report is not attached to the query here, so please upload it in the follow-up.

Also, please mention as to how old is your first child now and also the cause of cesarean section during the first pregnancy?

These are important. Also important shall be the non-stress report of your wife for establishing foetal well being and also if she is perceiving foetal movements well as on date, today?

The most important factor in considering a trial of labour post cesarean is the inter-delivery interval which should be more than 3 years and also the uterine scar thickness should be more than 3mm, to avoid any chances of uterine rupture.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Sameer Kumar 26 minutes later
Hi doc, I have emailed the reports to your team. My first child was born on 23rd April 2015. He was premature and was born on 35th week. The gynaecologist then cited some complications then which I cant think of exactly now, however I probably bleeded early a bit probably. Let me know if I need to get the stress test done, if so the exact name of the report.
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Answered by Dr. Sameer Kumar 2 hours later
Brief Answer:

answered

Detailed Answer:

Hello,

The USG report is fine but the pregnancy is borderline IUGR ( growth retarded by 2 weeks). The Doppler parameters and blood flow, baby weight are normal and so is the heart rate. The non-stress test is reactive at present.

Also considering your previous delivery likely due to antepartum haemorrhage and preterm, a cesarean is explained and 3 years is an ample time for the scar to hear.

Considering the present parameters, there is no indication for cesarean section as on today. You may again repeat the non-stress test after 3 days and compare the reports with your doctor.

You may be given a trial of labour if you proceed towards spontaneous labour else induction cannot be done with progesterone- only option would be foleys catheter induction.

If no pain till 40 weeks and 3 days of gestation, then post datism can be a cause which can be considered for repeat cesarean section.

Present count your baby movements, which should be more than 10 in 24 hrs. Discuss the same with your gynaecologist and take an informed decision.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Sameer Kumar 2 days later
Thanks Doc. After visiting the doc here he asked us to wait a couple of days then further asked for a scanning today again. From our end our objective is we can opt for a normal delivery. I am attaching the reports from todays scan. Can you advice.
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Answered by Dr. Sameer Kumar 30 minutes later
Brief Answer:

answered

Detailed Answer:

Hello,

the scan is absolutely normal and gestational age is 36 weeks + 2 days which is fine. I believe you had wrong dates Considering normal fl/ac RATIO, THE GROWTH of the foetus is normal.

The NST is also normal and still time to go for delivery possibly another 2 weeks. Get the weekly NST done to check foetal well being and wait for natural onset and progress of labour.

Please ask for uterine scar thickness report to be sure to initiate trial of labour after cesarean section. Keep your doctor in picture and discuss before opting for the step.

Hope I have answered your query.

Take care

Regards,
Dr Sameer Kumar, OBGYN
Above answer was peer-reviewed by : Dr. Kampana
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