Previous cesarean section and trial of labor. Factors related to uterine dehiscence

Abstract

Patients with previous cesarean section generally are subjected to repeat cesarean section for fear of uterine rupture and its subsequent catastrophic complications. Recently, however, since the practice of repeat cesarean section has been challenged, a select group of patients has been permitted a trial of labor (TOL) after they have fulfilled certain selection criteria. These criteria include not more than one previous low segment transverse incision, a nonrecurrent indication and absence of macrosomia with this pregnancy. We performed a retrospective study on 836 patients with previous cesarean sections. Of them, 308 were given a TOL. Factors considered to increase the risk of dehiscence were analyzed. On statistical analysis, none of the factors appeared to have any impact on the rate of uterine dehiscence.