| Labor after prior cesarean section. | |
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MedLine Citation:
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PMID: 1521374 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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1. All women with PCS should be considered candidates for vaginal delivery. Certain high-risk factors then should be used to recommend elective repeat cesarean section. Currently, a scar in the active segment of the uterus is considered an absolute contraindication to labor. 2. Women should be informed of the chances of success (which in most instances are excellent), course of action in labor, and the rare risk of uterine rupture. 3. Women in a very low risk category (one low-transverse PCS) should be managed like any laboring patient but including fetal monitoring. 4. The remaining laboring patients may benefit from more intensive intrapartum surveillance, including continuous electronic fetal monitoring, early rupture of the fetal membranes, and placement of an intrauterine pressure catheter. 5. The labor course in women with PCS will depend on the number of vaginal deliveries achieved previously and the stage of labor reached before the cesarean section was done. 6. Labor disorders in patients with PCS, as in all patients, should be diagnosed and managed promptly. 7. Neither oxytocin nor epidural use is contraindicated in these patients. As in any patient, care should be taken to avoid iatrogenic uterine hyperstimulation. 8. Uterine rupture may have many different presentations. However, the most common is abnormal fetal heart rate patterns that are especially variable or prolonged decelerations. 9. Most uterine ruptures can be repaired and do not require hysterectomy. Hysterectomy may be the appropriate choice in some situations. 10. A history of a prior uterine rupture is not a contraindication to future childbearing, but it may place the woman at greater risk for a repeat event. |
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Authors:
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G Pridjian |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Clinical obstetrics and gynecology Volume: 35 ISSN: 0009-9201 ISO Abbreviation: Clin Obstet Gynecol Publication Date: 1992 Sep |
Date Detail:
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Created Date: 1992-10-15 Completed Date: 1992-10-15 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0070014 Medline TA: Clin Obstet Gynecol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 445-56 Citation Subset: IM |
Affiliation:
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Department of Obstetrics & Gynecology, University of Michigan Medical School, Women's Hospital, Ann Arbor 48109-0264. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Humans Obstetric Labor Complications / diagnosis, etiology, physiopathology* Pregnancy Vaginal Birth after Cesarean* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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