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[Birth after two cesarean sections: the role of trial of labor]
F Bretelle1, C D'Ercole, L Cravello
1Service Obstétrique B, Hôpital de la Conception, Marseille.
Objective:
To study the management of labor following two cesarean sections, we evaluated maternal and neonatal morbidity subsequent to this attitude.
Patients And Methods:
A retrospective study was conducted over a 6-year period (1-1-1990 to 31-12-1995) in 184 women presenting two uterine scars. Trial of labor was allowed in 96 cases with cephalic presentation and a normal pelvis.
Results:
The rate of vaginal birth was 65%. Three patients presented a uterine scar dehiscence and in one of them hemostasis hysterectomy for uterine atony was performed. Neonatal outcome was good in all cases.
Conclusion:
Trial of labor after two cesarean sections is possible in the majority of cases. Rate of vaginal birth is high and maternal and fetal morbidity is low.