Vaginal Delivery Okay After C/S

Healthy women who have had a prior cesarean delivery can safely delivery vaginally. That is the conclusion of a 14-year retrospective study at the John H. Stroger Jr. Hospital of Cook County, IL.

Sylvia Moscoso, MD, and Tuan Nguyen, MD, reviewed records for women who had delivered by C/S between January 1990 and December 2003 at Cook County Hospital. The study group had a subsequent trial of labor with no intervening births, no medical or obstetrical complications during pregnancy, and delivered fetuses weighing more than 4,000 g. Just 62 women met study criteria, according to Dr. Moscoso. Twenty-two women (35.5%) chose to deliver vaginally and 40 women (64.5%) opted to deliver by repeat cesarean.

There were no statistically significant differences between the two groups in birth weights or Apgar scores at 1 and 5 minutes postpartum and none of the women had uterine rupture. There were two cases of shoulder dystocia in the vaginal delivery group, but neither infant had brachial plexus injuries. There were no significant maternal or neonatal morbidities in either birth group.

Based on the Chicago experience, healthy women with a previous C/S and no other deliveries who expect to deliver a fetus weighing over 4,000 g can be counseled that vaginal delivery is a viable birth option.

Moscoso S, Nguyen TM. Trial of labor after cesarean delivery and fetuses more than 4,000 g: The 14-year experience at Cook County. Obstet Gynecol. 2005;105(4 suppl):41S.