Caesarean Section and Trial of Scar

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Abstract
A retrospective study over a 16-year interval at the Mercy Maternity Hospital was made to analyse the contribution made by repeat Caesarean to the overall Caesarean section rate. The practice of trial of scar was examined with reference to the selection of patients, the conduct of labour, and the risks incurred by the mother and infant. The literature has been reviewed. The overall Caesarean section rate was 13.1% with 39.1% being repeat Caesarean sections. The primary rate has increased from 6.6% to 9.3% while the incidence of repeat Caesarean has increased from 2.7% to 6.8%. Of the 4,892 patients with one or more previous Caesarean sections, 1,577 (32.0%) were allowed a trial of scar, 1,197 (75.9%) of whom achieved a vaginal delivery. Thirteen patients sustained a ruptured uterus (0.82%) and 2 of the infants died (perinatal mortality 0.13% due to this complication alone).

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