Vaginal birth following two previous cesarean sections

Objective: To evaluate the management of vaginal delivery among women with two previous cesarean sections. The maternal and fetal morbidities of this attitude were studied. Setting: University hospital. Design: Retrospective study made over 6 years, from January Ist 1990 to December 31st 1995. Patie nts: Among 180 patients with two uterine scars, 96 patients with cephalic p resentation and normal pelvic dimensions were allowed trial of labor. Resul ts: The rate of vaginal birth following trial of labor was 65.6%. Three pat ients had an uterine scar dehiscence; among them, one hysterectomy was perf ormed for haemorrhage with uterine atony. Neonatal issue was always favorab le. Twenty-two newborns had superior birthweights: compared to those born f rom the preceding cesarean section. Conclusion: Trial of labor following tw o previous cesarean sections is acceptable in the majority of cases. It lea ds to a high vaginal delivery rate and low maternal and fetal morbidity. (C ) 2001 Elsevier Science Ireland Ltd. All rights reserved.