[Delivery conduction in patients with cicatrix of a prior cesarean section. Pilot study].
BACKGROUND
In the clinical practice there is an increasing number of patients with a previous cesarean section.


OBJECTIVE
1. The description of the evolution of patients with previous cesarean section and the possibility of a vaginal delivery. 2. To compare, in patients in labor, a pharmacological approach (ocitocic conduction and peridural anesthesia) vs a spontaneous evolution.


METHODS
-a clinical, random and prospective study. We analyze: age, parity, cause of previous cesarean section, obstetrical conditions at the moment of hospitalization, route of delivery, maternal and neonatal complications and days of hospitalization.


METHODS
univariable with single frequency and bivariable with contingency table (chi2) and comparison of means (T test).


RESULTS
Incoming to the study of 81 cases. Sixteen per cent were operated on without labor. Eighty four per cent (n-68) were separated randomly into two groups: 26 pharmacologically managed and 42, with a spontaneous approach. Within the first group, 84.6% delivered vaginally; the latter group, 88.1%, delivered vaginally. The only variable with a statistically significant difference was the greater cervical dilatation in the spontaneous grop at the moment of hospitalization.


CONCLUSIONS
The probability of vaginal birth after cesarean section is 72.8%, which increases to 86.7% in labor spontaneously initialized. The active management doesn't differ in this study, which has a 10% of power, of spontaneously management.
Arraztoa
J A
JA
Servicio de Maternidad, Hospital San José.
Jensen
L
L
Clavero
M
M
Castillo
H
H
D000328:Adult; D002921:Cicatrix; D005260:Female; D006801:Humans; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D016064:Vaginal Birth after Cesarean
Conducción del parto en pacientes con cicatriz de cesárea anterior. Estudio piloto.