Study of vaginal delivery in patients with one previous lower segment caesarean section.

This retrospective study evaluated the prospects of having a vaginal delivery following a lower segment Caesarean section in Nehru Hospital; 685 (52%) of 1,315 patients with a previous Caesarean section were given a trial of vaginal delivery with a success rate of 69%. Vaginal breech delivery was allowed in 14 patients without affecting the outcome of term babies and without maternal morbidity or mortality. There were 12 cases (1.7% incidence) of scar disruption of which 4 were of scar rupture. There was no maternal or fetal death as a result of these disruptions even though 3 mothers had subtotal hysterectomy. Pitocin was used in 144 (21%) patients. Of the 12 cases of scar disruption 5 patients had received pitocin. There was no favourable influence of prior vaginal delivery on the success of the trial, and 3 patients with scar disruption had already had a vaginal delivery in addition to a lower segment Caesarean section.