[Trial of labor in the patient with a prior cesarean section].

The increasing incidence of cesarean births has become quite controversial. The practice of delivering virtually all women with prior cesarean section by repeat cesarean section is open to debate. To assess the risks and benefits of trial of vaginal birth in patients wlth prior cesarean sectioB, a retrospective review of the patients delivered at the Yamanashi Medical Universlty Hospltal was performed. There were 255 patients, 158 (62%) of whom underwent trial of labor and I34 (84.8%) achieved vaginal delivery. There is no maternal mortality or parinatal mortality attributed tke trial oflabor process. The incidence of"terine rupture and scar dehiscene was similar ln the trial of labor group and elective repeat cesarean group. We conclude that an active program for trial of labor, with certain exclusion criteria and within the means of our facility, seems to pose no additioRal risk.