title: Trial of labor in the patient with a prior cesarean birth.
abstract: The increasing incidence of cesarean birth has become quite controversial. The practice of delivering virtually all women with a prior cesarean section by repeat cesarean section is open to debate. In a large institutional practice, with rapid availability of all support services, selective attempts to deliver women vaginally, after a prior cesarean section, is appealing. A prospective 1-year study on all patients with a prior cesarean delivery commenced July 1, 1982. There were 1209 patients, of whom 751 (62%) underwent a trial of labor and 614 (82%) achieved vaginal delivery. There was no maternal mortality or perinatal mortality attributed to the trial of labor process. Oxytocin usage occurred in 38% of this population. The incidence of uterine rupture and scar dehiscence was similar in the various study subgroups. The overall group of women undergoing a trial of labor had significantly fewer postpartum complications and shorter hospital stays.
mesh_terms: D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005316:Fetal Distress / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D011247:Pregnancy; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000150:complications / Q000453:epidemiology; D014597:Uterine Rupture / Q000209:etiology