Conducting labor in women with previous caesarean section in a low gestational week. A prospective case-controlled study.
OBJECTIVE
To assess whether vaginal labor after a previous caesarean section in a low gestational week performed by means of a high placed U-section technique could be recommended by obstetricians as a sufficiently safe method of choice for pregnant women.


METHODS
Of 309 pregnant women with a history of a high placed U-section, 166 (53.7%) met the criteria for the subsequent vaginal delivery and agreed with it. In 78%, vaginal labor started spontaneously and in 22% it was induced due to postterm pregnancy or preterm rupture of membranes.


RESULTS
Vaginal labor was successful in 72.3% of women. Deliveries after spontaneous onset of uterine contractions (80%) were considerably more successful. In the group of women with induced labor, the success rate was below 50%. Uterine rupture was not encountered in the study group.


CONCLUSIONS
Vaginal labor after a previous high placed U-section is a sufficiently safe method of choice for selected groups of pregnant women, but it has to be mentioned that selecting criteria can only minimize and not entirely exclude the risk of uterine rupture.
Binder
Tomás
T
Departments of Obstetrics and Gynaecology, Second Medical Faculty, Charles University and Teaching Hospital Motol, Prague, Czech Republic. bindert@seznam.cz
Hájek
Zdenek
Z
Zoban
Petr
P
Plavka
Richard
R
D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D011446:Prospective Studies; D014597:Uterine Rupture / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000379:methods*