title: Vaginal birth after two or more cesarean sections: a five-year experience.
abstract: Allowing a trial of labor in patients who have had a single low transverse cesarean section has become increasingly accepted and widespread in the United States. Evidence with regard to the safety of this practice in patients with two or more prior cesarean births has, however, been sparse. We performed a retrospective review of the charts of 170 patients who had undergone two or more low transverse cesarean deliveries and subsequently delivered at Wishard Memorial Hospital between January 1, 1983, and December 31, 1987. Of 35 of these women who underwent a trial of labor, 27 (77%) had a successful vaginal delivery. No increase in maternal or fetal morbidity or mortality was associated with labor. The women who underwent trial of labor had fewer postpartum complications and shorter hospital stays. Although the number of patients in this study was small, growing evidence appears to support a trial of labor in patients with two or more prior cesarean sections as a safe and successful alternative to elective repeat cesarean section.
authors.forename: R S
authors.initials: RS
authors.lastname: Hansell
authors.forename: K B
authors.initials: KB
authors.lastname: McMurray
authors.forename: G R
authors.initials: GR
authors.lastname: Huey
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007902:Length of Stay; D008428:Maternal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014219:Trial of Labor