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Study of Vaginal Delivery in Patients with One Previous Lower Segment Caesarean Section
Author(s) -
Singh T. Kishor C.,
Barman S. D.,
Gupta A. N.
Publication year - 1986
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1986.tb01578.x
Subject(s) - medicine , caesarean section , vaginal delivery , lower segment caesarean section , obstetrics , incidence (geometry) , gynecology , pregnancy , genetics , physics , optics , biology
EDITORIAL COMMENT: The incidence of scar disruption in this series of trial of Caesarean section scars was 3.5% (5 of 144) when pitocin was used for induction or augmentation of labour, and 1.3% (7 of541) when pitocin was not used. This series sounds a warning that concern with today's high Caesarean section rate must not encourage us to overreact and to use oxytocin to improve prospects for vaginal delivery when a patient elects to have a trial of Caesarean section scar. Summary: This retrospective study evaluated the prospects of having a vaginal delivery following a lower segment Caesarean section in Nehru Hospital; 685 (52%) of 1,315 patients with a previous Caesarean section were given a trial of vaginal delivery with a success rate of 69%. Vaginal breech delivery was allowed in 14 patients without affecting the outcome of term babies and without maternal morbidity or mortality. There were 12 cases (1.7% incidence) of scar disruption of which 4 were of scar rupture. There was no maternal or fetal death as a result of these disruptions even though 3 mothers had subtotal hysterectomy. Pitocin was used in 144 (21%) patients. Of the 12 cases of scar disruption 5 patients had received pitocin. There was no favourable influence of prior vaginal delivery on the success of the trial, and 3 patients with scar disruption had already had a vaginal delivery in addition to a lower segment Caesarean section.