title: Cervical dilation at the time of cesarean section for dystocia -- effect on subsequent trial of labor.
abstract: OBJECTIVE
  To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital in Copenhagen capital area.
  
  
  METHODS
  All women with a prior cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010.
  
  
  METHODS
  Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural anesthesia and mode of birth was collected.
  
  
  RESULTS
  A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully or almost fully dilated cervix (9-10 cm) (p < 0.001). Among the women with a previous vaginal delivery prior to their cesarean section, the success rate for vaginal birth was 76.2%, in contrast to 48.9% in the group without a previous vaginal delivery (p < 0.01).
  
  
  CONCLUSIONS
  Women who had a trial of labor after a prior cesarean section for dystocia done late in labor and women with a vaginal delivery prior to their cesarean section had a greater chance of a successful vaginal birth during a subsequent delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark. hellabi@hotmail.com
authors.forename: Helle
authors.initials: H
authors.lastname: Abildgaard
authors.forename: Marie Diness
authors.initials: MD
authors.lastname: Ingerslev
authors.forename: Carsten
authors.initials: C
authors.lastname: Nickelsen
authors.forename: Niels Joergen
authors.initials: NJ
authors.lastname: Secher
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004420:Dystocia / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000502:physiology*; D011247:Pregnancy; D012189:Retrospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean