[Outcome of delivery following previous cesarean section]

Of 249 women whose last pregnancy was terminated by a caesarean section, 57 (22.9%) were delivered again by a primary caesarean section. The other 192 (77.1%) were allowed to attempt vaginal birth. Of these, 151 (60.6%) were successful, and 41 (16.5%) underwent a repeat caesarean section. The percentage of successful vaginal births was strongly correlated with the indication for the previous caesarean section. There was one case of incomplete uterine rupture. The maternal morbidity was lowest in the group who had a vaginal delivery. One child developed an Erb-Duchenne paralysis in addition to a mechanical birth trauma. In the secondary caesarean section group there were more children with a low one minute Apgar score than in the group delivered vaginally or by a primary caesarean section. It is concluded that there are sufficient arguments against routinely performing a repeat caesarean section after a previous one. The indication for the previous caesarean section can be an important aid in the selection of women to be allowed to try a vaginal delivery.