Induced labor in women with previous Cesarean section

Objective To evaluate the effectiveness and safety of induction of labor in women with previous Cesarean delivery. Method We induced labor in 98 women with a history of previous Cesarean del ivery in whom termination of gestation was indicated. Oxytocin was given to women with premature rupture of the membranes and to women with intact mem branes plus a Bishop index of > 7. Prostaglandin E-2 (0.5 mg) was given int racervically in one or two doses 24 h apart in women with intact membranes and a Bishop index of less than or equal to 7; this was followed by oxytoci n if labor had not begun 24 h after the second dose. The control group cons isted of 128 women with previous Cesarean delivery in whom labor had begun. Results There was no significant difference in the vaginal delivery rate be tween women in whom labor was induced (61.2%) and control women (68.8%). In dication for previous Cesarean section was the only variable significantly associated with successful trial of labor (p < 0.05). None of the patients had dehiscence of the scar or uterine rupture. Conclusion Induction of labor with intracervical prostaglandin E-2 and oxyt ocin alone or in combination in women with previous Cesarean delivery is a safe procedure for the mother and fetus.