THE MANAGEMENT OF LABOR IN WOMEN WITH MORE THAN ONE UTERINE SCAR - ISA REPEAT CESAREAN-SECTION REALLY THE ONLY SAFE OPTION

A prospective trial to investigate feasibility of vaginal delivera aft er more than one cesarean section, and the safety of vaginal delivery for mother and neonate. Twenty-six pregnant women with a history of tw o or more cesarean sections were admitted to the delivery room and acc epted trial of labor under internal fetal and uterine monitoring. Epid ural anesthesia and oxytocin were applied when needed. A similar group of patients (controls) preferred repeated cesarean section. Nineteen women (73%) were successfully delivered by the vaginal route. There we re no cases of uterine rupture or perinatal loss. The maternal complic ation rate was lower than that of the control group. Trial of labor in selected cases of two or more low-segment cesarean sections may be co nsidered safe for mother and fetus.