Update on delivery following prior cesarean section: a 15‐year review 1972–1987

Fear of true rupture remains the main indication for repeat section. Between 1972 and 1987 there were 2434 patients with one or more prior section and 1350 (55%) were permitted trial of labor, the remainder, having had two or more previous sections (maximum number, 10), had repeat surgery. Induction was employed in 31% and oxytocin for induction or acceleration in 32% patients. The first period (1972–1982) had 844 and the second period (1982–1987) had 506 trial of labor patients. Improved management resulted in the true rupture rate falling from 0.6% (1 : 169) to 0.2% (1 : 506) and the elimination of procedure‐related perinatal death. There were two maternal deaths with repeat section and none with trial of labor. We have achieved a plateau for cesarean section (10–11%) and a continuing fall in the uncorrected hospital perinatal mortality, which has averaged 10.6/1000 for the years 1982–1986 inclusive.