Vaginal birth following two previous cesarean sections.
OBJECTIVE
To evaluate the management of vaginal delivery among women with two previous cesarean sections. The maternal and fetal morbidities of this attitude were studied.


METHODS
University hospital.


METHODS
Retrospective study made over 6 years, from January 1st 1990 to December 31st 1995.


METHODS
Among 180 patients with two uterine scars, 96 patients with cephalic presentation and normal pelvic dimensions were allowed trial of labor.


RESULTS
The rate of vaginal birth following trial of labor was 65.6%. Three patients had an uterine scar dehiscence; among them, one hysterectomy was performed for haemorrhage with uterine atony. Neonatal issue was always favorable. Twenty-two newborns had superior birthweights compared to those born from the preceding cesarean section.


CONCLUSIONS
Trial of labor following two previous cesarean sections is acceptable in the majority of cases. It leads to a high vaginal delivery rate and low maternal and fetal morbidity.
Bretelle
F
F
Department of Obstetrics & Gynecology B, Hôpital de La Conception, 147 Bvd Baille, 13385, Cedex 5, Marseille, France.
Cravello
L
L
Shojai
R
R
Roger
V
V
D'ercole
C
C
Blanc
B
B
D015360:Analgesia, Epidural; D001724:Birth Weight; D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010120:Oxytocics / Q000627:therapeutic use; D011247:Pregnancy; D011312:Pressure; D014219:Trial of Labor; D014599:Uterus / Q000502:physiology; D016064:Vaginal Birth after Cesarean
D010120:Oxytocics