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A review of the results of vaginal delivery following caesarean section


Denis W.P. Lavery

Abstract

An analysis of the type of delivery which occurred after one previous delivery by  caesarean section was carried out on all patients attending Baragwanath Hospital  during the 15-month period October 1969 to December 1970. The group consisted of 485 patients who fitted the requirement of one caesarean section, and 72-9% succeeded in a vaginal delivery after a,./trial of scar'. The age and parity of the majority of the patients were consistent with the optimal obstetrical career of  women. The foetal loss as a direct result of the treatment was 3 babies who were  extruded into the abdominal cavity through a complete rupture of the scar (0-9%). Vaginal delivery was considered possible for 333 patients and 243 (72-9%)  succeeded, with a small partial rupture in one patient and a haematoma in the region of the extremity of the scar in another. Failure to deliver vaginally after a trial of scar occurred in 90 patients and the section was repeated. In this group 4 (4-4%)  developed a rupture of the scar, which was total and complete in 2 lower segment  sc~rs, in 1 unsuspected classical scar, and' partial in 1 lower segment scar. The incidence of scar rupture iro the tr'al group was 1-8%. The indications for the  previous caesarean section differed quite considerably from those of the repeat section while the infants' weights were essentially the same.

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eISSN: 2078-5135
print ISSN: 0256-9574