[Birth after two cesarean sections: the role of trial of labor].

Objective: To study the management of labor following two cesarean sections, we evaluated maternal and neonatal morbidity subsequent to this attitude.

Patients And Methods: A retrospective study was conducted over a 6-year period (1-1-1990 to 31-12-1995) in 184 women presenting two uterine scars. Trial of labor was allowed in 96 cases with cephalic presentation and a normal pelvis.

Results: The rate of vaginal birth was 65%. Three patients presented a uterine scar dehiscence and in one of them hemostasis hysterectomy for uterine atony was performed. Neonatal outcome was good in all cases.

Conclusion: Trial of labor after two cesarean sections is possible in the majority of cases. Rate of vaginal birth is high and maternal and fetal morbidity is low.