title: Vaginal birth after cesarean section in rural Zaire. Changing concepts.
abstract: The safety of trials of labor after cesarean section has yet to be established in developing countries. Centre Médical Evangélique is a referral hospital in rural northeastern Zaire. From August 1, 1989, to January 15, 1990, 33 women with previous cesarean deliveries were offered a trial of labor. Of them, 22 (67%) had successful vaginal deliveries. The indications for the previous cesarean section did not influence the outcome of the trial of labor. There was a high rate of immediate maternal morbidity but no significant long-term morbidity. The rate of uterine dehiscence was 9.1%. The perinatal death rate, 60.1/1,000, was similar to the overall rate for the institution. Trials of labor after cesarean section are a valid therapeutic option in developing countries.
authors.affiliation: Department of Medicine, Temple University Health Sciences Center, Philadelphia, Pennsylvania 19140.
authors.forename: P
authors.initials: P
authors.lastname: Nyirjesy
authors.forename: K M
authors.initials: KM
authors.lastname: Nyirjesy
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D003906:Developing Countries; D005069:Evaluation Studies as Topic; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology; D012017:Referral and Consultation; D008921:Religious Missions; D012086:Reoperation / Q000706:statistics & numerical data; D014219:Trial of Labor