| The case for trial of labor in the patient with a prior low-segment vertical cesarean incision. | |
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MedLine Citation:
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PMID: 9240598 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our purpose was to review recent obstetric literature detailing the subsequent delivery experience of patients with a prior low-segment vertical cesarean incision and to derive recommendations for practice on the basis of this information. STUDY DESIGN: Ten studies that included information about pregnancy outcome in patients with prior low-segment vertical cesarean operations were retrieved and reviewed from the American obstetric literature since 1981 and from a review of all abstracts presented annually since 1981 to the Society of Perinatal Obstetricians. RESULTS: Altogether, information about subsequent pregnancy outcome for 382 patients with prior low-segment vertical cesarean delivery was available for analysis. Among the 372 patients with complete patient population information, vaginal delivery was safely accomplished in 306 (82%). Four uterine ruptures (1.05%) have been reported, only one of which occurred after a single prior unextended low-segment vertical cesarean incision. Two ruptures occurred elsewhere on the lateral or posterior aspect of the uterus in subsequent pregnancies, and the fourth rupture occurred at the juncture of prior low vertical and transverse incisions. No perinatal mortality or permanent perinatal morbidity was encountered with these pregnancies. CONCLUSIONS: In the otherwise uncomplicated pregnancy the patient with one previous nonextended low-segment vertical cesarean incision should be considered to have a prior low-segment scar and as such be a candidate for trial of labor in her current singleton pregnancy. The same care, counseling, and caution should be exercised for this patient as for one with a prior low-segment transverse incision. |
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Authors:
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J N Martin; K G Perry; W E Roberts; E F Meydrech |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 177 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 1997 Jul |
Date Detail:
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Created Date: 1997-08-19 Completed Date: 1997-08-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 144-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Birth Weight Cesarean Section / methods*, standards Counseling Decision Making Female Gestational Age Humans Incidence Maternal Welfare Obstetric Labor Complications / epidemiology Physician's Practice Patterns Pregnancy Pregnancy Outcome Trial of Labor* Vaginal Birth after Cesarean / standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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