title: Is vaginal birth after two or more cesarean sections safe?
abstract: Fifty-five patients with a history of two or more cesarean sections underwent a trial of labor. Forty-two had had previous uterine incisions of unknown type, 11 had had low cervical transverse incisions, and two had had low vertical incisions. Twenty-five women (45%) had successful vaginal deliveries, and 30 (55%) received oxytocin augmentation of labor. The incidence of vaginal delivery was significantly lower in patients who required oxytocin augmentation (30 versus 64%, P less than .01). Three of the 55 patients had scar separation detected at the time of delivery. Two patients underwent hysterectomy. There were no maternal or neonatal deaths. A history of multiple cesarean sections need not exclude the patient from the option of trial of labor.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: K M
authors.initials: KM
authors.lastname: Pruett
authors.forename: B
authors.initials: B
authors.lastname: Kirshon
authors.forename: D B
authors.initials: DB
authors.lastname: Cotton
authors.forename: A N
authors.initials: AN
authors.lastname: Poindexter
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D010121:Oxytocin; D011247:Pregnancy; D012086:Reoperation; D012189:Retrospective Studies; D014219:Trial of Labor
chemical_list: D010121:Oxytocin