Uterine scar separation in patients undergoing trial of labor (TOL) in one army hospital.
Before the mid-1980s, repeat cesarean section was the usual method of delivering all patients who had a previous cesarean section. With cesarean section rates exceeding 20% in the 1980s, a concerted effort to reduce this high rate was formulated in all military teaching hospitals. One proposed method to decrease the overall cesarean section rate was to reduce the number of repeat cesarean sections. Trial of labor (TOL) with vaginal birth after cesarean section was one method of decreasing the high cesarean section rate. Although vaginal birth after cesarean section has a relatively high success rate and has been shown to be safe for mother and infant, TOL is not risk free. One of the potential complications of TOL is uterine scar separation, which may lead to perinatal mortality. This report discusses uterine scar separation during TOL during a 1-year period at one medium-size U.S. Army teaching hospital.
Wittich
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Department of Surgery, DeWitt Army Community Hospital, Fort Belvoir, VA 22060-5901, USA.
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data / Q000639:trends; D002921:Cicatrix / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006772:Hospitals, Military; D006784:Hospitals, Teaching; D006801:Humans; D011247:Pregnancy; D012086:Reoperation / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control; D014219:Trial of Labor; D014768:Virginia