Routine revision of uterine scar after prior cesarean section

B. Kaplan*, M. Royburt, Y. Peled, M. Hirsch, M. Hod, Y. Ovadla, A. Neri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Up until the early seventies fear of uterine rupture led to the widespread practice of ‘once a section, always a section’. Nowadays, there is a consistent trend toward vaginal birth after a prior cesarean delivery, making early detection of uterine scar dehiscence at delivery important. However. the need for routine transcervical revision of the uterine scar following vaginal deliver) is controversial in the medical literature. The present study reviewed 467 women who underwent vaginal delivery following a previous cesarean section. In 414 patients the scar Was examined transcervically, and not one case of dehiscence of the scar was detected. The patients included four with twin pregnancies, and four with breech presentations (two underwent external cephalic version). Intrauterine pressure was monitored in 17 cases; Prostaglandin E2, vaginal tablets were used in 46 patients. and in 14 cases labor was augmented by Pitocin. Our results suggest that routine revision of a uterine scar at the time of a subsequent vaginal delivery is usually unnecessary. 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

Original languageEnglish
Pages (from-to)473-475
Number of pages3
JournalActa Obstetricia et Gynecologica Scandinavica
Volume73
Issue number6
DOIs
StatePublished - Jul 1994

Keywords

  • dehiscence
  • transcervical examination
  • uterine rupture
  • vaginal delivery

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