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Vaginal birth following two previous cesarean sections
F Bretelle1, L Cravello, R Shojai
1Department of Obstetrics & Gynecology B, Hôpital de La Conception, 147 Bvd Baille, 13385, Cedex 5, Marseille, France.
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 1st 1990 to December 31st 1995.
Patients:
Among 180 patients with two uterine scars, 96 patients with cephalic presentation and normal pelvic dimensions were allowed trial of labor.
Results:
The rate of vaginal birth following trial of labor was 65.6%. Three patients had an uterine scar dehiscence; among them, one hysterectomy was performed for haemorrhage with uterine atony. Neonatal issue was always favorable. Twenty-two newborns had superior birthweights compared to those born from the preceding cesarean section.
Conclusion:
Trial of labor following two previous cesarean sections is acceptable in the majority of cases. It leads to a high vaginal delivery rate and low maternal and fetal morbidity.