Trial of labor in previous cesarean section patients, excluding classical cesarean sections

Obstet Gynecol. 1987 Nov;70(5):713-7.

Abstract

The American College of Obstetricians and Gynecologists has supported the concept of a trial of labor in patients with a previous lower uterine transverse cesarean section, and its safety is generally accepted. The purpose of this report was to present the results of a year-long, prospective study in which the indications for trial of labor were liberalized. Only patients with a previous classical incision or "T" incision on the uterus were excluded. Two hundred seventy-two patients elected to undergo a trial of labor. Vaginal delivery occurred in 216 patients (76.5%). Oxytocin was used as needed, and epidural anesthesia was used in all patients who requested it. One uterine rupture occurred in a patient with a single lower transverse scar. The results of this study suggest that a trial of labor is a safe alternative for patients with a previous single or multiple lower uterine transverse incision or a lower uterine vertical incision. In addition, the use of epidural anesthesia and oxytocin appears safe in patients undergoing a trial of labor.

MeSH terms

  • Anesthesia, Epidural
  • Anesthesia, Obstetrical
  • Cesarean Section* / methods
  • Cicatrix / pathology
  • Female
  • Humans
  • Length of Stay
  • Oxytocin
  • Pregnancy
  • Reoperation
  • Trial of Labor*
  • Uterine Rupture / etiology

Substances

  • Oxytocin