Outcome of trial of labor in patients with a single previous low transverse cesarean section for dystocia.
The purpose of this prospective investigation was to evaluate the outcome of trial of labor in women with a history of a single low transverse cesarean section for dystocia in comparison with the outcome in women with a history of cesarean delivery for a reason other than dystocia. During the study period, 89 of 131 patients (68%) with a history of dystocia had a successful trial of labor, compared with 78 of 96 women (81%) who had cesarean delivery for a reason other than dystocia (P less than .025). Within the former group, 79% of women who originally had surgery while still in the latent phase of labor had a successful trial of labor, compared with 61% (.05 less than P less than .10) of patients who had an arrest of dilation in the active phase of labor and 65% (not significant) of those who had an arrest of descent. The only serious complication among study patients was a single instance of uterine scar dehiscence (0.5%). We conclude that approximately two-thirds of patients with a previous cesarean delivery for dystocia will have a successful trial of labor. Of these women, those individuals whose initial operation was performed in the latent phase of labor appear to have the best prognosis for subsequent vaginal delivery.
Duff
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Division of Maternal-Fetal Medicine, Madigan Army Medical Center, Tacoma, Washington.
Southmayd
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Read
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D000005:Abdomen; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000209:etiology; D036861:Delivery, Obstetric; D004420:Dystocia / Q000601:surgery*; D004716:Endometritis / Q000209:etiology; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D010146:Pain / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D013529:Surgical Wound Dehiscence / Q000209:etiology