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Vaginal delivery after 3 previous caesarean sections.

G W Lawson1

  • 1Western Suburbs Maternity Hospital, Newcastle, New South Wales.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|May 1, 1987
PubMed
Summary
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A trial of scar after three prior Cesarean sections was successful. The patient had a vaginal birth with forceps, and her uterus remained intact without complications.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Trial of scar (TOS) is an option for women with prior Cesarean sections.
  • Previous Cesarean sections increase risks in subsequent pregnancies.
  • Careful monitoring is crucial for successful TOS.

Purpose of the Study:

  • To evaluate the safety and outcome of a trial of scar in a patient with a history of three previous Cesarean sections.
  • To assess the integrity of the uterine scar after a trial of scar and vaginal birth.

Main Methods:

  • A patient with 3 previous Cesarean sections underwent a trial of scar.
  • Spontaneous labor at 39 weeks gestation was closely monitored.
  • Delivery was assisted with a Wrigley forceps lift-out.

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Main Results:

  • The labor was uneventful and lasted 3.5 hours.
  • No maternal or neonatal morbidity was observed.
  • The uterine scar was found to be intact post-delivery.

Conclusions:

  • A trial of scar can be a safe option for carefully selected patients with multiple prior Cesarean sections.
  • Successful vaginal birth after multiple Cesarean sections is achievable with meticulous monitoring and management.
  • Preservation of uterine scar integrity is possible in trial of scar cases.