Outcome of labour in patients with a lower segment caesarean scar

Abstract

Of 450 patients with previous caesarean sections, 280 (62 per cent) were given a trial for vaginal delivery, with a success rate of 58 per cent. Vaginal delivery was achieved by 56 per cent of patients who underwent the previous caesarean section for obstructed labour or failure to progress. Previous vaginal delivery favours a successful outcome of labour. Twenty-three per cent of the patients received either intravaginal prostaglandin E2 tablets or oxytocin for induction or augmentation of labour. The drugs were found to be safe and effective in increasing the vaginal delivery rate. There were four cases of scar disruption (1.4 per cent); one was related to oxytocin infusion. Vaginal breech delivery was successful in six patients without maternal and fetal morbidity or mortality. Trial for vaginal delivery may be allowed in selected patients with a previous lower segment caesarean section in a well equipped hospital department. © 1989 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.