Vaginal delivery after caesarean section: is it safe in a developing country?
Many studies from developed countries have shown that a trial of vaginal delivery after a Caesarean section can be a safe alternative to repeated Caesarean section when certain criteria are fulfilled. However, few data are available from developing countries where, in most cases, there is no electronic fetal heart rate monitoring, no information about the prior section and no X-ray pelvimetry. At Gweru Hospital, 401 patients with a scarred uterus have been managed according to a standard protocol and 288 were allowed to have a trial of scar. The results show that the trial was successful in 235 mothers (82%) and there were only 2 uterine ruptures (0.7%). Postpartum morbidity was higher after Caesarean section than after vaginal delivery.
De Muylder
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Department of Obstetrics and Gynaecology, Gweru Provincial Hospital, Zimbabwe.
D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D003906:Developing Countries; D005260:Female; D005313:Fetal Death; D005323:Fetal Monitoring; D006801:Humans; D007744:Obstetric Labor Complications; D011247:Pregnancy; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology