title: Vaginal delivery after previous caesarean section for failure of second stage of labour.
abstract: OBJECTIVE
  To determine the outcome of subsequent labour in primiparous women after a caesarean section for delay in descent in the second stage of labour in cephalic presentations with or without trial of instrumental vaginal delivery.
  
  
  METHODS
  Retrospective follow up study.
  
  
  METHODS
  Medical Centre Leeuwarden, The Netherlands.
  
  
  METHODS
  All primiparous parturients who delivered after prior caesarean section during the second stage of labour in the period 19861998.
  
  
  METHODS
  Data concerning the outcome of the first subsequent delivery were gathered from delivery notes and patients charts. The group of women was subdivided into those with or without trial of instrumental vaginal delivery during the previous labour.
  
  
  RESULTS
  Of 132 women, 29 (22%) underwent a planned repeat caesarean section. Of the 103 women who were allowed a trial of labour, 82 (80%) were successful in having a vaginal delivery, and 21 (20%) had a second caesarean section. Of the 74 women with a failed trial of instrumental delivery during the previous labour, 19 had a planned repeat caesarean section and 41 of the remaining 55 (75%) had a successful trial of labour.
  
  
  CONCLUSIONS
  In women with a cephalic presentation who had an arrest of descent in the second stage of labour during their first delivery, the chances of vaginal delivery in their next pregnancy are high, even after a failed instrumented vaginal delivery, and a trial of labour can usually be pursued.
authors.affiliation: Department of Obstetrics and Gynaecology, Medical Centre Leeuwarden, The Netherlands.
authors.forename: V H
authors.initials: VH
authors.lastname: Jongen
authors.forename: M G
authors.initials: MG
authors.lastname: Halfwerk
authors.forename: W K
authors.initials: WK
authors.lastname: Brouwer
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D003657:Decision Making; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology; D016064:Vaginal Birth after Cesarean