Document Detail


Outcome of a trial of labor after prior cesarean delivery.
MedLine Citation:
PMID:  6708017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the United States over 90% of patients with a history of cesarean delivery in the prior pregnancy undergo repeat cesarean delivery in a subsequent pregnancy. The costs of the nearly universal approach to this issue are staggering and have been addressed by a recent National Institutes of Health consensus development conference. In 1979 at the Women's Hospital of Los Angeles County/University of Southern California Medical Center we initiated a policy of permitting a trial of spontaneous labor and vaginal delivery in selected patients with prior cesarean deliveries. Patients selected for a trial of labor (TOL) were those with a history of one prior uterine incision known to be low transverse. During 1980 there were 13,292 deliveries and 13,147 live births; 871 of these patients had a history of prior cesarean delivery. Of the 871 women, 308 (35%) were permitted a TOL. There were 240 vaginal deliveries, for a success rate of 78%. Twenty-two perinatal deaths occurred among the 871 patients, none directly attributable to the TOL. There were three ruptured uteri, one directly attributable to a TOL. Seven hysterectomies were performed in this group, none directly attributable to a TOL. This experience has encouraged us to expand the patient group offered a TOL after prior cesarean delivery under carefully controlled conditions.
Authors:
G S Eglinton; J P Phelan; S Yeh; F P Diaz; T M Wallace; R H Paul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  29     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  1984 Jan 
Date Detail:
Created Date:  1984-05-17     Completed Date:  1984-05-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section*
Female
Humans
Hysterectomy
Infant Mortality
Infant, Newborn
Labor, Obstetric*
Pregnancy
Reoperation
Retrospective Studies
Surgical Wound Dehiscence

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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