Vaginal delivery after cesarean section. Experience in private practice. 1983

E Gellman, and M S Goldstein, and S Kaplan, and W J Shapiro

To test whether vaginal delivery after cesarean section (VDAC) is a safe alternative to repeated section, a retrospective chart review of 2,350 deliveries during a ten-year period in a private practice group committed to VDAC was studied. Eighty-five parturients met six predetermined safety criteria and were permitted a trial of labor. These criteria were (1) prior low-segment transverse uterine incision; (2) vertex presentation; (3) carefully monitored labor with obstetrician present; (4) availability of emergency facilities; (5) no administration of oxytocin; and (6) patients' consent and desire to pursue VDAC. Seventy-six labors (89%) managed expectantly were successful in VDAC. No maternal or fetal morbidity was detected. No uterine ruptures were detected on postpartum examination or at the time of cesarean section. These results support the 1980 report of the National Institute of Child Health and Human Development recommending that labor and VDAC are of low risk to mother and fetus in properly selected cases.

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
D007258 Informed Consent Voluntary authorization, by a patient or research subject, with full comprehension of the risks involved, for diagnostic or investigative procedures, and for medical and surgical treatment. Consent, Informed
D007746 Labor Presentation The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK. Fetal Presentation,Presentation, Fetal,Fetal Malpresentation,Fetal Malpresentations,Malpresentation, Fetal,Presentation, Labor
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
D011331 Private Practice Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice. Solo Practice,Practice, Private,Practice, Solo,Practices, Private,Practices, Solo,Private Practices,Solo Practices
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
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative

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