Induction of labor after caesarean section: current trends

• Evgeniya K. Belyaeva
• Yulia D. Vuchenovich
• Nadezhda M. Startseva

Abstract

By the end of the first quarter of the 21^st century, the world does not have unambiguous recommendations for the delivery of women with an operated uterus, which made the “uterine scar” the main indication for repeated abdominal delivery and the first place in the structure of all сaesarean sections (CS). Controversies of this provision have been developed over the past 30 years, but this problem has not been unambiguously solved, there are many reasons for this: first of all, this is the fear of rupture of the uterus along the existing scar. The “problem within the problem” is the preparation of birth canal for programmed delivery, which significantly reduces the incidence of CS both with the operated uterus and with the intact one. Allowing a vaginal delivery attempt avoids complications associated with reoperation, but requires a comprehensive risk assessment. Planned induction of labor in this cohort of pregnant women is becoming an increasingly common obstetric intervention and represents a wide field for discussion.

The aim of this study was to form a systematic review of literature data on methods of induction/pre-induction of labor in women with an uterine scar after CS.

Material and methods. The analysis of literature data from the leading bibliographic sources: PubMed, MEDLINE, Cochrane – was carried out. The electronic search period was from January 1, 2017 to September 1, 2022.

Conclusion. Successful induction of labor increases vaginal delivery rate and, in general, reduces abdominal delivery rate. All methods of preparing birth canal by means permitted in each individual country are subject to further study.

Keywords:methods of induction of labor; induction of labor after caesarean section; attempted vaginal delivery after caesarean section

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