PubMed · 7016394
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K A Kappy. 1981. Vacuum extractor.. https://pubmed.ncbi.nlm.nih.gov/7016394/
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OBJECTIVES: A retrospective study of decisions made in a gynaecology department between January 1990 and December 1993 were analyzed in order to assess management of the post-cesarean uterus. METHOD: Among 9092 women who delivered in the department during the study period, there were 641 patients with a post-cesarean uterus, due to a single prior cesarean section in 451. Results were analyzed and compared with those reported in the literature. RESULTS: Among the 451 patients with a single scar, 184 (41%) delivered by elective cesarean section and in 267 (59%) a decision was made during labour. In this group of 267 patients with a single cicatrix who underwent a labour tests, 227 (85%) had a vaginal delivery compared with 40 (15%) in which the decision for cesarean section was made during labour. CONCLUSION: The results observed were comparable with those found in the literature. Management of pregnancy with post-cesarean uterus is now quite similar to that of a normal uterus. Epidural anaesthesia and ocytotin therapy as well as epidural labour triggering have had an important effect.
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With any operative vaginal delivery, it is important to document in the medical record the indications for the procedure, including the position and station of the vertex and specifics of technique, timing, and ease of the procedure. The use of cord pH and blood gas determinations may be helpful for further evaluation of the fetus.