Unknown uterine scar and trial of labor.
A review of 393 patients undergoing trial of labor after one or more previous cesarean sections was performed. Three hundred patients had an unknown uterine scar, 88 patients had a documented low cervical transverse incision, and five patients had a prior low vertical incision. The rate of vaginal delivery and maternal and fetal morbidity was no different in those patients with an unknown prior uterine incision compared with those having a known prior low cervical transverse incision. In 66 of the patients with a documented low cervical transverse incision, the original operative record was reviewed in regard to single-layer closure of the uterine incision versus double-layer closure or imbricating technique. No patient with a double-layer uterine closure had a subsequent dehiscence, whereas three patients with a prior single-layer closure exhibited scar separation. These data suggest that neither an unknown scar nor a single-layer uterine closure places the mother or fetus at greater risk.
Pruett
K M
KM
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030.
Kirshon
B
B
Cotton
D B
DB
D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D002921:Cicatrix / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D011645:Puerperal Infection / Q000209:etiology; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology; D014599:Uterus / Q000473:pathology* / Q000601:surgery
D010121:Oxytocin