VAGINAL DELIVERY AFTER PREVIOUSLY PERFORMED CESAREAN-SECTION

In a retrospective study covering a period of 15 years (1976-1991), we investigated 673 births after previous caesarean section compared to a matched pair group. During the observation period, an increase of va ginal delivery after previous caesarean section occurred. This decreas e in resection rate (first five years period: 59%, 60% in the period o f 1981-1985 and 42% within the last five years) could be achieved main ly in births after only one previous caesarean section. In patients wi th more than one previous caesarean section, the resection rate remain ed almost stable at 95%. The rate of complication was low in our study group, especially, if compared to studies in the USA. Three uterine r uptures with one maternal death occurred during the entire observation period. No correlation of the complication rate with an increase of v aginal delivery was observed. The more conservative obstetrical manage ment had no negative impact on foetal outcome.