Trial of labor after an earlier cesarean section. A conservative approach

Between 1980 and 1984 a conservative protocol for a trial of labor was applied for parturients with an earlier cesarean section in the Department of Obstetrics and Gynecology, Hospital Nacional Valdecilla, Santander, Spain. The protocol had been devised for and underwent a trial for future use in district hospitals with only standard obstetric facilities. Use of the protocol was based mainly on careful case selection and precluded the use of oxytocin. Three hundred thirty-nine patients underwent a trial of labor during the study period. Of them, 202 (59.6%) had a successful vaginal delivery. No uterine ruptures or scar dehiscence occurred. There was one antepartum death, of a grossly malformed, nonviable fetus.