Background: the likelihood of successful vaginal delivery is affected by various factors. We aimed to assess the factors that are associated with successful vaginal delivery following cesarean section CS. Methods: This was a prospective observational study that assessed the effect of maternal age, parity, antenatal care visit, gestational age, history of medical illness, smoking history, indication for past cesarean section, inter delivery interval, history of previous successful vaginal birth after cesarean section VBAC, past spontaneous vaginal delivery, membrane status on admission, cervical dilatation on admission, duration of labour, meconium stained liquor on the likelihood of achieving vaginal delivery following a previous CS. Results: about 500 pregnant women with previous one lower segment CS were included in the study, 83% (415/500) achieved with successful (VBAC), and 17 % (85/500) ended with failed trial of labour after cesarean section (TOLAC). Fifty –eight percent of the participants with successful VBAC had a history of vaginal delivery. Conclusion: success rate of VBAC is high and TOLAC is safe for most of pregnant women who attempt to deliver vaginally after one CS. Successful VBAC may help in decision making and contribute to a reduction in cesarean delivery rates and reduce maternal morbidity and mortality associated with repeated CS.

Background: Transverse vaginal septum is a congenital mullerian malformation resulting from failure of fusion or canalization of the urogenital sinus and the mullerian ducts. This results in amenorrhoea, inability to consummate marriage and primary infertility if left untreated. It is a rare finding in pregnancy and labor. Objectives: The objective of this study was to review the management and outcome of patients with transverse vaginal septum. Materials and Method: It was a retrospective study where data from medical records of all cases of transverse vaginal septum managed over a10-year period (January 2008 to December 2017) were collected and reviewed. There were 18 patients managed over the period of study, however 16 case folders were retrieved and 2 were missing. Results: The patients’ ages ranged between 16 and 40 years, with a mean (+SD) age of 23.3(+7.7) years. They had varying presenting symptoms including lower abdominal pain in 15(93.7%), lower abdominal swelling in 8(53.3%), dyspareunia in 9(56.2%), primary amenorrhoea in 12(75%) and failure of coital penetration in 9 (56.2%) patients. The septum was imperforate in 12(75.0%) and perforate in 4 (25.0%) patients. The septum was located in the lower third of the vagina in 13 (78.6%) patients and at mid and upper portions in 1(7.1%) and 2(14.3%) patients respectively. Some of the patients (31.2%) had previous surgery prior to presentation. Fourteen (87.5%) were managed via perineal approach and 2(12.5%) via abdominoperineal route. Most patients, (68.8%) did not develop any complication, however 4(25%) had re-obstruction and only 1(6.2%) had vaginal stenosis. Conclusion: Transverse vaginal septum is a rare anomaly of the female genital tract. The most common symptom was lower abdominal pain and the predominant type was the low type. The main treatment modality was surgical with significant success.

Background and objective: Defined as the collection of blood between the chorionic membrane and the uterine wall, subchorionic hematoma can be associated with adverse pregnancy outcomes and even miscarriage. The present study was carried out in order to evaluate the effects of first-trimester subchorionic hematoma on pregnancy outcomes. Patients and methods: The present study was an observational prospective case-control study which was conducted on 200 pregnant women in Erbil teaching hospital, Erbil, Iraq over a period of one year from April 2019 to April 2020. The women were assigned into two groups, a case group consisting of 100 women with subchorionic hematoma and a control group including 100 women without subchorionic hematoma. Required data were collected based on the women’s full history and examination. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS version 25.0). Results: age of most of women in our study was between 20-30 years old, although we couldn’t find any association between subchorionic hematoma and age of the woman. Most of the cases (97%) and controls (95%) did not smoke (p-value=0.721). The cases and controls were not significantly different in terms of miscarriage, most of them did not have miscarriage (p-value=0.182). The results revealed a significant association between current miscarriage and history of previous miscarriage (p-value<0.001). The cases and controls were not significantly different in terms of 2nd and 3rd trimester vaginal bleeding, mode of delivery, intrauterine fetal death, newborn admission to NCU, congenital anomalies, age, parity, Apgar score in first minute, and Apgar score in 5th minute (p-value>0.05). However, they were significantly different regarding their birth weight (p-value=0.12). Conclusion: There are no significant correlations between having subchorionic hematoma and miscarriage; however, the odds of miscarriage are slightly higher in women with subchorionic hematoma. Newborns of women with subchorionic hematoma generally have a lower birth weight.