VAGINAL DELIVERY AFTER ONE CESAREAN-SECTION

Objective: To determine the success rate and safety of vaginal delivery after a previous cesarean section in a South African teaching hospital serving a developing community. Method: One hundred eighty-nine women with a history of one previous cesarean section were studied during a 10.5-month period. Maternal morbidity was studied in 92 of these patients who had infants weighing 2500 g or more. During the study period 5044 women delivered at the hospital. Results: In the study group of 189 women, 85 (44.9%) delivered vaginally, 65 (34.4%) by cesarean section during labor and 39 (20.6%) had elective cesarean sections. One maternal and two perinatal deaths occurred. In the subgroup of 92 women with babies weighing 2500 g or more at birth, 10 women (10.9%) experienced morbidity related to trial of scar. Conclusion: Vaginal birth was accomplished less often in this population compared with reports from developed countries, but the procedure was equally safe.