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KMID : 0376219820190040631
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Chonnam Medical Journal
1982 Volume.19 No. 4 p.631 ~ p.637
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A Clinical Study on Delivery after Previous Cesarean Section
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Abstract
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This study was based on retrospective investigation of the 172 cases of delivery after previous cesarean section from January 1, 1978 to December 31, 1982at the department of Obstetrics and Gynecology, Chonnam University Hospital.
The results were as follows;
1) Indication for previous cesarean section were cephalopelvic disproportion in 82 (47.7 %) cases, breech in 21(12.2%), transverse lie in 17(9.9%), fetal distress in 14(8.1 %) and placenta previa in 14(8.1 %).
2) A trial labor was attempted in 68(39.5%) cases with successful vaginal. delivery in 26(38.2%).
3) Relation between indication for previous cesarean section and cases allowed a trial of labor. In 24 cases where the indication for the primary cesarean section had been cephalopelvic disproportion, only 2 had a vaginal delivery, 24 required repeat cesarean section.
4) Indication for repeat cesarean section without trial were cephalopelvic disproportion and wanted tubal ligroin in 40(38.5%) cases, previous classic section in 20(19.2%), previous section/over 2 times in 16(15.4%) and previous section/unknown method in 12(11.5%).
5) The uterine incision at the preceding operation had been lower segment in 140(81.4.%) cases, upper segment in 20(11.6%) and unknown in 12(7.0%).
6) Indication for cesarean section after failed trial were cephalopelvic disproportion or failure to progress in 32(76.2%) cases, fetal distress in 4(9.5%), uterine dysfunction in 4(9.5%) and cord prolapse in 2(4.8%).
7) State of uterine scar; Complete rupture of uterus had occurred in 4 cases, incomplete rupture in 2 and dehiscence in 2 cases. Of the cases of ruptured scar 4 complete rupture and 2 incomplete rupture occurred in upper segment scar and 6 ruptures were all emergency cases. 2 dehiscence occurred in lower segment scar.
8) There were 6 stillbirths (3.4%) and 3 neonatal death (1.7%). Corrected mortality rate was 0.6%.
9) There was no maternal death in the 172 cases.
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