Factores relacionados con la vía de parto tras cesárea anterior

The aim of this study was to evaluate the rate of vaginal birth after a previous cesarean in our population. A retrospective study was performed through a review of the clinical histories of the 258 women with a previous cesarean section that delivered in our hospital between 2005 and 2007. Women with more than one prior cesarean section, classical uterine incision or any absolute contraindication for vaginal delivery were excluded. Delivery was through the vaginal route in 59.3%. Fifty-five percent of the women began spontaneous delivery, 21.7% were induced and cesarean section was scheduled in 23.3%. Of the variables studied, the highest rates of vaginal birth were produced with spontaneous labor, when Bishop's score was ⩾6 (88.51%) and when there was a history of vaginal birth before a cesarean section (66.7%) or after a cesarean section (84.25%). The lowest rates of vaginal delivery (42.2%) were obtained when the previous indication for cesarean section was dystocia (no progression/disproportion). There were no cases of uterine rupture in our study and maternal and fetal complications did not increase. In conclusion, vaginal birth is feasible in almost 60% of women with a prior cesarean section and does not increase fetal and maternal complications.