[Vaginal delivery following cesarean section]

An analysis is presented of the outcome of labour in 462 women with a previous caesarean section, who delivered in the department of obstetrics of Leiden University Hospital in the period 1977-1986. Elective repeat section was performed in 26% of these women, while 83% of those accepted for a trial of labour had a vaginal delivery. In 196 women with a history of a previous caesarean section (1984-1986) a retrospective analysis was made of the influence of the indication for the previous caesarean section with respect of the outcome of labour in the following pregnancy. A trial of labour had the highest chance of success in those who had had a previous caesarean section because of a breech presentation. Sixty-five percent of women who had had a prior caesarean section because of cephalopelvic disproportion or failure to progress delivered by the vaginal route after a trial of labour. Foetal weight estimation by ultrasound could not predict the outcome of a trial of labour. It is concluded that a trial of labour after a previous caesarean section, even when the operation was performed because of cephalopelvic disproportion or failure to progress, is safe and rational.