Trial of labor in previous cesarean section patients, excluding classical cesarean sections.
The American College of Obstetricians and Gynecologists has supported the concept of a trial of labor in patients with a previous lower uterine transverse cesarean section, and its safety is generally accepted. The purpose of this report was to present the results of a year-long, prospective study in which the indications for trial of labor were liberalized. Only patients with a previous classical incision or "T" incision on the uterus were excluded. Two hundred seventy-two patients elected to undergo a trial of labor. Vaginal delivery occurred in 216 patients (76.5%). Oxytocin was used as needed, and epidural anesthesia was used in all patients who requested it. One uterine rupture occurred in a patient with a single lower transverse scar. The results of this study suggest that a trial of labor is a safe alternative for patients with a previous single or multiple lower uterine transverse incision or a lower uterine vertical incision. In addition, the use of epidural anesthesia and oxytocin appears safe in patients undergoing a trial of labor.
Stovall
T G
TG
Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Memphis.
Shaver
D C
DC
Solomon
S K
SK
Anderson
G D
GD
D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section / Q000379:methods; D002921:Cicatrix / Q000473:pathology; D005260:Female; D006801:Humans; D007902:Length of Stay; D010121:Oxytocin; D011247:Pregnancy; D012086:Reoperation; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology
D010121:Oxytocin