LABOR INDUCTION IN PATIENTS WITH PREVIOUS CESAREAN-SECTION

To determine the efficacy and safety of labor induction in patients pr eviously delivered by at least one low transverse cesarean section, a retrospective review was done at a single tertiary perinatal center, t he University of Florida Health Science Center, Jacksonville. All pati ents with a previous cesarean section who required labor induction fro m 1988 until the end of 1992 were identified. Duration and outcome of labor induction, including mode of delivery, maternal and perinatal mo rbidity, and birth trauma, were evaluated. Of 160 patients with a prev ious cesarean, 50 (31.3%) had a repeat operation compared to 18 (11.2% ) in the no previous cesarean group (p = 0.001, odds ratio = 3.59; 95% confidence interval, 1.98, 6.49). Women in the cesarean group had a h igher incidence of operative vaginal deliveries, prolonged duration of the first and second stages of labor, rate and maximum dose of oxytoc in infusion. One patient in the previous cesarean group experienced ut erine rupture. There was no difference in the rate of infants with low 5-minute Apgar scores or with cord pH values less than 7.20. Labor in duction in women with previous low transverse cesarean sections result s in an acceptable rate of vaginal delivery and appears safe for both mother and fetus.