Obstetric and Neonatal Outcome in Second-Pregnancy Patients with One Prior Cesarean Section at A Costarican Hospital 2006-2007

Aim: To analyze neonatal and obstetric outcomes in second-pregnancy patients with 1 prior cesarean section.

Materials and methods: This study is a cross-sectional observational study. We analyzed 306 medical records of patients treated at the Dr. Rafael A. Calderón Guardia Hospital (HCG), from January 1st 2006 to December 31st of 2007. Maternal variables associated to prenatal control were age and obstetrical indication of the previous cesarean delivery. Variables associated to delivery were gestational age, type of delivery, obstetric complications, and length of hospital stay. The neonatal variables were weight at birth, 5 minute Apgar score, neonatal complications, need for neonatal resuscitation or newborn hospitalization and length of hospital stay.

Results: 59, 1% of the patients with 1 prior cesarean section had successful vaginal delivery. The percentage of maternal complications was significantly higher for those who underwent a cesarean section during labor.

Uterine rupture occurred in 1,3% of the cases and no maternal or neonatal deaths were found as a consequence of such complication. The percentage of neonatal complications was similar for both groups. The need for neonatal resuscitation was significantly higher in the group that underwent an elective caesarean delivery.

Conclusion: Our results show that at the HCG from January 1st 2006 to December 31st of 2007, a vaginal delivery in second-pregnancy patients with 1 prior caesarean delivery appears to be safe. The percentage of successful vaginal deliveries, obstetric complications and uterine rupture were similar to those reported in international literature.