DefinePK

Abstract

Background: Induction of labor (IOL) in women with a previous cesarean section remains a clinically sensitive decision due to concerns about uterine rupture and maternal morbidity. However, when carefully selected, IOL may provide a safe and effective alternative to repeat cesarean delivery. Prostaglandin E2 (PGE2) is commonly used for cervical ripening and has shown favorable outcomes in inducing labor. This study aimed to evaluate the maternal outcome of labor induction in women with a history of one prior lower segment cesarean section.
Objective: To determine the maternal outcome of induction of labor in pregnant women with a previous cesarean scar.
Methods: This descriptive study was conducted at the Department of Obstetrics and Gynecology, Saidu Sharif Medical College, Swat, from June to December 2024. A total of 145 pregnant women aged 15 to 40 years with a single previous lower segment cesarean section and confirmed second or third trimester pregnancies were enrolled using non-probability consecutive sampling. Induction was carried out using prostaglandin E2 (1.5 mg vaginal tablets) administered every 8 hours, with a maximum cumulative dose of 18 mg. Maternal outcomes were categorized as successful vaginal delivery or cesarean section. Data were analyzed using SPSS version 20.
Results: The mean maternal age was 28.76 ± 7.44 years, and the mean gestational age was 34.06 ± 4.57 weeks. Mean duration since previous uterine scar was 23.08 ± 5.15 months, and 30.3% of participants had a history of prior vaginal delivery. Successful vaginal delivery was achieved in 79 women (54.5%), while 66 (45.5%) underwent repeat cesarean section.
Conclusion: Labor induction using prostaglandin E2 in women with one prior cesarean scar can result in favorable vaginal delivery outcomes when patient selection and clinical monitoring are appropriately conducted.