[The course of pregnancy and fetal outcome after cesarean section].

The management of pregnant women with a history of one or more previous caesarean sections has gained enormous importance in view of the increased frequency of delivery by this operative procedure over the past decade. The risks of pregnancy and delivery in this particular group of women have been investigated in this statistical study of 316 women, whereby special attention has been paid to the mode of delivery and fetal outcome in comparison with a matched-pair group of the same parity. Repeat caesarean section was required in 58.9% of the test group and vacuum extraction or forceps delivery was necessary in 7.9% of cases, the incidence of these operative procedures being far higher than in the control group. However, the fetal outcome was very similar in both groups, with an uncorrected perinatal mortality of 2.5% and 1.9% in the test and control groups, respectively. The 1' and 5' Apgar scores were worse in those newborn infants delivered by vaginal operation or emergency caesarian section. The vaginal delivery of women with a history of caesarean section is not only perfectly feasible, but is connected with little risk provided mother and fetus are monitored with utmost care.