Question

Trial of labour in previous caesarean section can be done in?

• A. Placenta previa type III
• B. Previous two classical caesarean section
• C. Suspected CPD
• D. Previous caesarean section with adequate pelvis

Hint:

Which option describes a favourable factor rather than a contraindication?

Answer 1

The Correct Option is D

Step 1: A trial of labour after caesarean (TOLAC) is an attempt at vaginal birth in a woman with a previous caesarean section. Its success depends on a low risk of scar rupture and the absence of any fresh indication for repeat caesarean.

Step 2: The single most important favourable factor is an adequate maternal pelvis with no cephalopelvic disproportion, ideally with one previous lower segment caesarean done for a non-recurrent cause. This makes option (d) the correct answer.

Step 3: Placenta previa type III (option a) is a major degree of previa that obstructs the os and mandates caesarean, so it contraindicates a trial of labour.

Step 4: A previous classical (vertical upper segment) caesarean, especially two of them (option b), carries a high risk of scar rupture and is a contraindication. Suspected cephalopelvic disproportion (option c) is itself a reason the labour will likely obstruct, so a trial is unsafe.