Cg. Zorlu et al., VAGINAL BIRTH FOLLOWING UNMONITORED LABOR IN PATIENTS WITH PRIOR CESAREAN-SECTION, Gynecologic and obstetric investigation, 42(4), 1996, pp. 222-226
Following a previous cesarean section, trial labor followed by spontan
eous birth is currently popular but is still debatable. In an effort t
o assess the risks of unmonitored labor. the outcomes of 165 patients
with previous cesarean section who delayed coming to hospital were rev
iewed. Seventy-one patients were allowed to continue labor and 62 achi
eved successful vaginal delivery, a success rate of 87.3%, Sixty-one o
f 71 patients had an unknown uterine scar type prior to birth and, of
these, 57 were delivered vaginally. The scar separation rate of this g
roup was found to be 3.5% and the overall scar separation rate in our
patients was 3.6%. Other than scar separation and febrile morbidity, n
o maternal morbidity or mortality was observed. The vast majority (98.
4%) of infants delivered vaginally had 5-min Apgar scores of 7 or grea
ter. We suggest that increasing the use of trial labor in patients wit
h prior cesarean section, even in the presence of an unknown scar, may
reduce the number of patients laboring in an unmonitored environment
who wish to give birth vaginally.