Induction of labor in patients with a previous cesarean birth

Kim, Yoon Ha; Song, Tae Bok; Kim, Hyoung Choon; Kim, Ki Min; Lee, Kung Chol; Kim, Seok Mo; Byun, Ji Soo

Abstract

OBJECTIVE
To determine the efficacy and safety of labor induction in patients previously delivered by a low transverse cesarean section. METHOD: A retrospective review was done at Chonnam National University Hospital, Kwangju, Korea. All patients with a previous cesarean section who required labor induction from April, 1986 to June, 1999 were identified. Outcome of labor induction, including mode of delivery, maternal and perinatal morbidity, and birth trauma were evaluated.
RESULTS
Trial of labor was undertaken by 1256 women(55.8%) who had previously been delivered by a low transverse cesarean section. 973 patients(77.5%) with a previous cesarean birth had a spontaneous onset of labor. Labor was induced in 283 patients(22.5%) with a previous cesarean birth. Successful vaginal delivery rate were 82.9%(807/973) in spontaneous labor and 79.2%(224/283) in induced labor group (p= NS). There were no differences in uterine dehiscence and rupture rate, perinatal and maternal mortality rate, and the rate of infants with low 1 or 5-minute Apgar scores between patients attempting a trial of labor after cesarean, spontaneous and induced.
CONCLUSION
we conclude that labor induction in patients with a previous low transverse cesarean section is a safe procedure requiring close peripartum maternal and fetal surveillance.