VAGINAL BIRTH FOLLOWING UNMONITORED LABOR IN PATIENTS WITH PRIOR CESAREAN-SECTION

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.