Trial of scar with induction/oxytocin in delivery following prior section. 1988

F P Meehan
Department of Obstetrics and Gynaecology, University College Galway, Ireland.

During the ten year study period, April 1972 to March 1982, there were 1,498 patients, with one or more prior caesarean section delivered at the Regional Hospital, University College, Galway. Trial of scar (TOS) was undertaken in 844 (56.34%) patients and the remaining 654 (43.66%) had a repeat elective caesarean section. There were 546 (64.69%) TOS patients who had some form of induction/augmentation and in 269 (49.26%) oxytocin was used, singularly and in combination with other induction methods and successful vaginal delivery was attained in 222 (82.52%) patients. There was no increased incidence of true rupture (TR) or bloodless dehiscence (BD) associated with the use of induction/augmentation or oxytocin in this series. There was a 50% perinatal mortality associated with TR, but there was no maternal death in TOS patients, with or without a successful trial. An incidence of TR of 1:169 patients is no justification for the "once a section, always a section" idiology, widely practiced in North America today.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007751 Labor, Induced Artificially induced UTERINE CONTRACTION. Induced Labor,Induction of Labor,Labor Induced,Labor Induction,Induced, Labor,Induction, Labor,Inductions, Labor,Labor Inductions
D010121 Oxytocin A nonapeptide hormone released from the neurohypophysis (PITUITARY GLAND, POSTERIOR). It differs from VASOPRESSIN by two amino acids at residues 3 and 8. Oxytocin acts on SMOOTH MUSCLE CELLS, such as causing UTERINE CONTRACTIONS and MILK EJECTION. Ocytocin,Pitocin,Syntocinon
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D002921 Cicatrix The fibrous tissue that replaces normal tissue during the process of WOUND HEALING. Scars,Cicatrization,Scar,Scarring
D005113 Extraction, Obstetrical Extraction of the fetus by means of obstetrical instruments. Extraction, Obstetric,Extractions, Obstetric,Extractions, Obstetrical,Obstetric Extraction,Obstetric Extractions,Obstetrical Extraction,Obstetrical Extractions
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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