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[Special obstetric problems in managing labor following cesarean section]
J Wessel1, G Ralph, W Lichtenegger
1Universitätsfrauenklinik Charlottenburg der Freien Universität Berlin.
The prevalence of primary repeat cesareans in the 37th and 38th weeks of gestation and the highest rate of premature births explain the shorter duration of pregnancy associated with this mode of delivery. In cases where ecbolics were administered labour was prolonged and the rate of secondary repeat cesareans was higher. Late rupture of the amniotic sac seems to increase the chances of successful vaginal delivery. Biparietal cranial diameter had no influence on the mode of delivery; significantly higher values were found only in cases of cranial-pelvic incongruity. The frequency of primary repeat cesareans increased in proportion to the age of the mother. The time interval since the previous cesarean delivery is of no importance. Birth weights were lower in the group of elective repeat cesareans owing to lower gestational age. It does not always appear justified to rule out a vaginal birth in cases of twins. Regional anesthesia is not a contraindication.
The prevalence of primary repeat cesareans in the 37th and 38th weeks of gestation and the highest rate of premature births explain the shorter duration of pregnancy associated with this mode of delivery. In cases where ecbolics were administered labour was prolonged and the rate of secondary repeat cesareans was higher. Late rupture of the amniotic sac seems to increase the chances of successful vaginal delivery. Biparietal cranial diameter had no influence on the mode of delivery; significantly higher values were found only in cases of cranial-pelvic incongruity. The frequency of primary repeat cesareans increased in proportion to the age of the mother. The time interval since the previous cesarean delivery is of no importance. Birth weights were lower in the group of elective repeat cesareans owing to lower gestational age. It does not always appear justified to rule out a vaginal birth in cases of twins. Regional anesthesia is not a contraindication.