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Vaginal Delivery After 3 Previous Caesarean Sections
Author(s) -
Lawson Gerald W.
Publication year - 1987
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.1987.tb00957.x
Subject(s) - medicine , forceps , forceps delivery , vaginal delivery , caesarean section , obstetrics , episiotomy , pregnancy , surgery , biology , genetics
EDITORIAL COMMENT: When Caesarean section is performed for the standard indications and trial of scar considered in the next pregnancy, it will seldom be necessary to perform trial of scar after 3 Caesarean sections as reported here. However, this provocative case report, together with the review of similar examples in the literature, indicates that in the unusual patient who requests trial of scar after more than I Caesarean section, this obstetrical finesse is not reprehensible — provided that the labour is monitored with meticulous care, and, in our view, conducted without either induction of labour, oxytocin augmentation, epidural analgesia, or difficult forceps delivery. One reviewer of this paper still has the impression that trial of scar after multiple Caesarean section is inherently dangerous! This case also illustrates how important it is to try to avoid the first Caesarean section. Summary: A patient who had had 3 previous Caesarean sections was permitted a trial of scar in her subsequent confinement. Labour occurred spontaneously at 39 weeks, and was closely monitored. After an uneventful labour of 3 1 / 2 hours, a Wrigley forceps lift‐out was performed. There was no maternal or neonatal morbidity and the uterine scar was intact.