To explore the delivery mode of patients with prior cesarean section, and the safety and feasibility of vaginal delivery after cesarean section.

From January 2004 to December 2009, 387 cases of pregnancy delivery after cesarean section were recruited into this study. They were divided into two groups according to different method of delivery, observation group (n=32, virginal delivery) and control group (n=355, cesarean section). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Centre for Capital University of Medical Sciences. Informed consent was obtained from all participants. The following indexes were compared between two groups: 24 h post-partum bleeding volume, neonatal Apgar score, length of stay, hospital charges, etc.

The successful rate of vaginal delivery was 78.0% (32/41) with no uterine rupture. The rest of 355 cases were chosen to accept cesarean section. There had statistically significant differences of postpartum hemorrhage, puerperal morbidity, length of stay, hospital charges between two groups (P<0.05), but had no significant difference of incidence of neonatal asphyxia (P>0.05).

Most of the patients with prior cesarean section could deliver safely through vaginal labor, if the indication and contraindication of vaginal labor were grasped strictly and the labor processes were observed intensively. Pregnancy after cesarean section is not a absolute indicator for cesarean section again.