Planned vaginal delivery following cesarean section.

A program of trial labor by patients who had previously undergone one low cervical transverse cesarean section is described. Experience with 526 such patients shows that 49% delivered vaginally, doing so with slightly less morbidity and a shorter hospital stay than 108 similar patients not given a trial labor. Perinatal mortality and morbidity were unaffected by trial or route of delivery. Uterine rupture was encountered three times in the trial group and once in the nontrial patients but at no time resulted in a serious threat to the mother or child. Fertility was retained in 2 of the 4 patients. A significant increase in maternal morbidity was noted among patients whose trial labor resulted in a repeat cesarean section.