Vaginal delivery after cesarean section Symposium on difficult labor and delivery

M. J. O'Sullivan, F. Fumia, K. Holsinger, A. G W McLeod

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

The incidence of cesarean scar rupture varies from 0.64 to 1.24%, with some institutions reporting no ruptures. Associated maternal mortality is extremely low, especially in low segment transverse incisions, so as to be almost nonexistent. Maternal mortality from cesarean section is higher than from vaginal delivery. Fetal mortality as a result of low segment scar rupture is at most 12.5%. With modern methods of monitoring this should be reduced to zero. Several authors already report no fetal mortalities. Patients who have had a previous cesarean section should be allowed an attempt to deliver vaginally based on carefully selected criteria. Their labors should be followed closely by a qualified individual and are expected to follow a normo-progressive course. The intrauterine cavity should be explored postpartum for defects. The cost of hospital care to the family is considerably reduced, and hospital bed utilization improved by allowing vaginal deliveries of women who have had previous cesarean sections, because of decreased operative risks, postpartum morbidity, and shorter hospital stays. The recovery period for the patient who delivered vaginally will generally be considerably reduced. Each subsequent pregnancy in which vaginal delivery is contemplated must be screened and managed as though it were her first after a section. Physicians should not charge different fees for elective repeat cesarean section versus vaginal delivery of the previous cesarean. Allowing a trial of labor in carefully selected patients is one step toward decreasing the cesarean section rate.

Original languageEnglish
Pages (from-to)131-143
Number of pages13
JournalClinics in Perinatology
Volume8
Issue number1
StatePublished - Jan 1 1981
Externally publishedYes

Fingerprint

Cesarean Section
Fetal Mortality
Rupture
Maternal Mortality
Postpartum Period
Cicatrix
Repeat Cesarean Section
Trial of Labor
Fees and Charges
Hospital Costs
Length of Stay
Morbidity
Physicians
Pregnancy
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

O'Sullivan, M. J., Fumia, F., Holsinger, K., & McLeod, A. G. W. (1981). Vaginal delivery after cesarean section Symposium on difficult labor and delivery. Clinics in Perinatology, 8(1), 131-143.

Vaginal delivery after cesarean section Symposium on difficult labor and delivery. / O'Sullivan, M. J.; Fumia, F.; Holsinger, K.; McLeod, A. G W.

In: Clinics in Perinatology, Vol. 8, No. 1, 01.01.1981, p. 131-143.

Research output: Contribution to journalArticle

O'Sullivan, MJ, Fumia, F, Holsinger, K & McLeod, AGW 1981, 'Vaginal delivery after cesarean section Symposium on difficult labor and delivery', Clinics in Perinatology, vol. 8, no. 1, pp. 131-143.
O'Sullivan MJ, Fumia F, Holsinger K, McLeod AGW. Vaginal delivery after cesarean section Symposium on difficult labor and delivery. Clinics in Perinatology. 1981 Jan 1;8(1):131-143.
O'Sullivan, M. J. ; Fumia, F. ; Holsinger, K. ; McLeod, A. G W. / Vaginal delivery after cesarean section Symposium on difficult labor and delivery. In: Clinics in Perinatology. 1981 ; Vol. 8, No. 1. pp. 131-143.
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