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

Original Article

Korean Journal of Obstetrics & Gynecology 2001;44(2):290-295.
Published online February 1, 2001.

Induction of labor in patients with a previous cesarean birth.

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

Departments of Obstetrics and Gynecology, Chonnam University Medical School, Kwangju, Korea.

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.

Key Words: previous cesarean birth, trial of labor, labor induction