Vaginal delivery following caesarean section.

A retrospective analysis was made of 456 patients who had previously undergone Caesarean section and who were considered suitable for a trial of labour. Sixty percent of patients had a vaginal delivery. Patients with obstructed labour or failure to progress as the indication for primary Caesarean section were significantly more likely to require a repeat operation but 44% of these patients still achieved a vaginal delivery. Patients who had had a vaginal delivery prior to, or subsequent to, the Caesarean section had a low incidence of repeat Caesarean section. X-ray pelvimetry was of limited value in predicting outcome. Intravenous oxytocin was used in 17% of patients. No uterine rupture occurred and no fetal mortality resulted directly due to the trial of labour. Trial of labour following Caesarean section is a safe procedure when conducted in an appropriate hospital setting.