Cesarean delivery in nulliparous women for failed oxytocin-augmented labor: route of delivery in subsequent pregnancy.

Fifty-eight patients experienced cesarean section for termination of their first term pregnancy subsequent to a failed trial of oxytocin therapy. Cephalopelvic disproportion and "failure to progress" were the sole indications for the initial cesarean section. All 58 women returned to our hospital for a subsequent trial of labor during the years 1977-1979 inclusive, and 40 of the 58 were able to have a vaginal delivery. Parameters investigated included first and subsequent pregnancy birth weights; birth weight difference; duration and maximal dose of oxytocin; status of the cervix at admission, prior to oxytocin, and before cesarean section; and the clinical and/or radiologic estimation of pelvic dimensions. Subsequent birth weight less than 3,500 gm was the only statistically significant factor associated with a high rate of vaginal delivery.