Success of Vaginal Deliveries Among Women in Labor with Previous Cesarean Section: Analysis of 50 Cases

This study was purposed to evaluate the success of vaginal deliveries after cesarean (VBAC). This case-series-study was conducted in Zainoel Abidin and Ibu dan Anak Hospital, as referral and teaching Hospitals, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, from January until October 2011 with descriptive analytic method. The outcomes were the success of VBAC. There were 50 subjects attempted VBAC. From 50 subjects who attempted VBAC, 45 subjects (90%) were succeed in vaginal delivery, 5 subjects (10%) were unsuccessful and had to undergo emergency C-Section. The parameters which were likely to contribute to the success of vaginal delivery in subjects who attempted VBAC were gestational age less than 40 weeks, the progress of cervical dilatation of less than 1 cm in 60 minutes, more ripened cervix on the labor. Parameters such as lower baby's weight and history of vaginal delivery also result in the success of VBAC. Gestational age, Bishop score, and the progress of cervical dilatation contributed to higher success of VBAC

Grave\u27s Disease in 32-34 Weeks of Pregnancy

The objective of the present case report was to improve knowledge in the management of pregnancy and delivery with Graves\u27 disease in 32-34 weeks of pregnancy. Primigravida with Graves\u27 disease was detected at 28 weeks gestational age in patients Mrs. H, 26 years old came with complaints : shortness of breath, leg sweeling, a lump in the neck, the eyes stood out, finger tremors, can not stand the heat, often sweaty, the hearts was tachycardia, increased appetite but weight doesn\u27t increase and even decreased 8 kg since last five years ago. Patients had a history of goitre since five years ago, with an irregular treatment. Pregnancy can be maintained after being treated in Departement of Obstetrics and Gynaecology and routinely controlled to assess fetal wellbeing. At 32-34 weeks of gestational age, the pregnancy was terminated by caesarean section, born baby boy, 1930 gr, Apgar Score 8/9. Mother was in good condition after caesarean section. Baby was dead in six days after birth with respiratory distress syndrome DD/ pneumonia aspiration. Hyperthyroidism which not handled will have a serious complications, but if properly handled and monitored, maybe the results of maternal and fetal outcomes expected good. Antepartum fetal assessment include fetal heart rate, the amount of amniotic fluid can be a parameter for pregnancy termination planning. The results of poor outcomes are things that must be observed that Graves\u27 disease in pregnancy have a risk of neonatal mortalit