[Birth after two cesarean sections: the role of trial of labor].
OBJECTIVE
To study the management of labor following two cesarean sections, we evaluated maternal and neonatal morbidity subsequent to this attitude.


METHODS
A retrospective study was conducted over a 6-year period (1-1-1990 to 31-12-1995) in 184 women presenting two uterine scars. Trial of labor was allowed in 96 cases with cephalic presentation and a normal pelvis.


RESULTS
The rate of vaginal birth was 65%. Three patients presented a uterine scar dehiscence and in one of them hemostasis hysterectomy for uterine atony was performed. Neonatal outcome was good in all cases.


CONCLUSIONS
Trial of labor after two cesarean sections is possible in the majority of cases. Rate of vaginal birth is high and maternal and fetal morbidity is low.
Service Obstétrique B, Hôpital de la Conception, Marseille.
F
F
Bretelle
C
C
D'Ercole
L
L
Cravello
L
L
Piéchon
V
V
Roger
L
L
Boubli
B
B
Blanc
D005260:Female; D006801:Humans; D009017:Morbidity; D007744:Obstetric Labor Complications / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012086:Reoperation; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects* / Q000379:methods