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The article is devoted to the issue of vaginal delivery after a previous cesarean section, considers the state of the problem in the world, provides considerations for some features of labor in these cases and their impact on the decision of the doctor. The objective:is to investigate the features of vaginal delivery after a previous cesarean section. Materials and methods.The features of labor of 46 patients with previous cesarean section (group I), 30 nulliparous (group II) and 30 multiparous (group III) was analyzed. The duration of the first period of labor, the duration of the latent phase, the duration of the second period of labor, as well as the frequency of major obstetric complications were studied. Results.It is demonstrated, that the average duration of the first period of labor and the latent phase of this period after the previous cesarean section are close to the first labor. In contrast, in women who give birth vaginally after a previous cesarean section, the processes of shortening and smoothing of the cervix occur in parallel, as is typical for second labor. Also, these women are more prone to slowing down the strength and intensity of contractions, the dynamics of the opening of the cervix than nulliparous and multiparous without history of cesarean section. No differences in the time of rupture of membranes, the duration of the second period of labor and the frequency of other obstetric complications was not detected. Conclusions.1. The vaginal delivery after previous cesarean section has certain physiological features that should be considered when assessing the effectiveness of labor, namely – the duration of the first period of childbirth is corresponding to the first labor, and the sequence of changes in the cervix (smoothing, opening) – to recurrent labor. Such births are more often characterized by a slowdown in the rate of opening of the cervix. 2. The frequency of major obstetric complications (meconium impurities in amniotic fluid, placental abruption, hypotonic haemorrhage) by vaginal delivery after a previous cesarean section is not greater than in other vaginal deliveries. |
