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Update on delivery following prior cesarean section: a 15‐year review 1972–1987
Author(s) -
Meehan F.P.,
Burke G.,
Kehoe J.T.
Publication year - 1989
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(89)90403-7
Subject(s) - medicine , section (typography) , obstetrics , falling (accident) , oxytocin , perinatal mortality , pregnancy , pediatrics , fetus , environmental health , biology , advertising , business , genetics
Abstract Fear of true rupture remains the main indication for repeat section. Between 1972 and 1987 there were 2434 patients with one or more prior section and 1350 (55%) were permitted trial of labor, the remainder, having had two or more previous sections (maximum number, 10), had repeat surgery. Induction was employed in 31% and oxytocin for induction or acceleration in 32% patients. The first period (1972–1982) had 844 and the second period (1982–1987) had 506 trial of labor patients. Improved management resulted in the true rupture rate falling from 0.6% (1 : 169) to 0.2% (1 : 506) and the elimination of procedure‐related perinatal death. There were two maternal deaths with repeat section and none with trial of labor. We have achieved a plateau for cesarean section (10–11%) and a continuing fall in the uncorrected hospital perinatal mortality, which has averaged 10.6/1000 for the years 1982–1986 inclusive.