Update on delivery following prior cesarean section: a 15-year review 1972-1987.
Fear of true rupture remains the main indication for repeat section. Between 1972 and 1987 there were 2434 patients with one or more prior section and 1350 (55%) were permitted trial of labor, the remainder, having had two or more previous sections (maximum number, 10), had repeat surgery. Induction was employed in 31% and oxytocin for induction or acceleration in 32% patients. The first period (1972-1982) had 844 and the second period (1982-1987) had 506 trial of labor patients. Improved management resulted in the true rupture rate falling from 0.6% (1:169) to 0.2% (1:506) and the elimination of procedure-related perinatal death. There were two maternal deaths with repeat section and none with trial of labor. We have achieved a plateau for cesarean section (10-11%) and a continuing fall in the uncorrected hospital perinatal mortality, which has averaged 10.6/1000 for the years 1982-1986 inclusive.
Meehan
F P
FP
Department of Obstetrics and Gynaecology, University College Galway, Ireland.
Burke
G
G
Kehoe
J T
JT
D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007226:Infant Mortality; D007751:Labor, Induced; D010121:Oxytocin / Q000008:administration & dosage; D011247:Pregnancy; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D014219:Trial of Labor; D014481:United States; D014597:Uterine Rupture / Q000209:etiology
D010121:Oxytocin