Document Detail

Vaginal birth after cesarean section in a university setting.
MedLine Citation:
PMID:  8051495     Owner:  NLM     Status:  MEDLINE    
Despite numerous reports in the literature almost universally endorsing the safety of a trial of labor after a prior cesarean section, it is used in only a small fraction of eligible patients. Our investigation, conducted at the University of Louisville, examines the safety of such a protocol. Two thousand seven hundred fifty-seven patients were delivered during one year; 282 had a history of at least one prior cesarean section. Of the 259 patients eligible, 218 (84%) underwent a trial of labor, and 168/218 (77%) were delivered vaginally. There were 6 cases of uterine dehiscence and 1 uterine rupture. No hysterectomies were performed. Maternal morbidity was significantly greater in the failed trial-of-labor group. There was one perinatal death that was unrelated to a trial of labor. A previous diagnosis of cephalopelvic disproportion or failure to progress did not preclude a trial of labor, and 69% of these patients delivered vaginally. Our data suggest that a trial of labor following one or more previous cesarean sections is a safe option in a carefully selected population.
M A Turnquest; T James; C Marcell; J A Spinnato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of the Kentucky Medical Association     Volume:  92     ISSN:  0023-0294     ISO Abbreviation:  J Ky Med Assoc     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-09-06     Completed Date:  1994-09-06     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7505615     Medline TA:  J Ky Med Assoc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  216-21     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Louisville, KY 40292.
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MeSH Terms
Cesarean Section / adverse effects
Infant, Newborn
Obstetric Labor Complications
Trial of Labor
Vaginal Birth after Cesarean*

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