[Trying vaginal delivery in 1000 patients with previous cesarean section in the Antiguo Hospital Civil de Guadalajara]

Because of the main justification for practicing a cesarean section is due to a previous cesarean and the rasing rates frequency of this operation, we concluded a descriptive and prospective investigation in order to analize the factibility and security of vaginal delivery after one cesarean section. We include 1000 patients with a past history of one previous cesarean section and with the following main characteristics: normal evaluation of the actual pregnancy and a gestational age of at least 36 weeks of pregnancy, no pelvis stenosis and a normal fetal status. The management were expectant and or with the use of oxitocin, prostaglandin PGEJ, uterionhibition and or amnioinfusion according to medical indication, 679 (67.9%) patients had a vaginal delivery; one ruterine rupture (0.001 x 1000) happened (the place of the rupture were not in the scar of the previous cesarean); two uterine dehicence (0.002 x 1000) of the previous uterine scar; one of this require laparotomy and sture of the dehiscence scar and the other one only require observation. We had two intrapartum fetal dead (0.002 x 1000) on due to the uterine rupture and the other one because of a taquisitolia not corrected by betamimetics. The factibility and security of vaginal delivery after one previous cesarean section is a logical and reasonable strategy in order to decrease the actual high rates of cesarean section. Whenever we try a viginal delivery in a patients with one previous cesarean is imperative to keep in mind that if something is not going well during the attempts we must repeat another cesarean.