A complication after a previous caesarean section

doi:10.1136/bmj.b2979

Published 12 August 2009, doi:10.1136/bmj.b2979
Cite this as: BMJ 2009;339:b2979

Endgames

Case report

A complication after a previous caesarean section

Niamh Barrett, registrar in obstetrics and gynaecology¹, Sharon R Sheehan, research fellow², Deirdre J Murphy, professor of obstetrics²

¹ Coombe Women and Infants’ University Hospital, Dublin 8, Ireland, ² Coombe Women and Infants’ University Hospital and Trinity College Dublin

Correspondence to: S Sheehan sharon.sheehan@tcd.ie

The first 150 words of the full text of this article appear below.

A 38 year old woman booked for antenatal care in her secondpregnancy. Her first baby had been delivered by emergency caesareansection after failed induction of labour. She had an uncomplicatedantenatal course and hoped to achieve a vaginal delivery. At39 weeks’ gestation she presented in spontaneous labourwith regular uterine contractions. The fetus was of averagesize and in a cephalic presentation, with two fifths of thehead palpable abdominally. On vaginal examination, the cervixwas 5 cm dilated and clear liquor was draining. She was reassessedafter two hours and had progressed to 9 cm dilation with thevertex 2 cm above the ischial spines. The cardiotocograph atthat time was reassurring.

The obstetric registrar was called to review the patient 20minutes later because of deep late decelerations on the cardiotocographand fresh vaginal bleeding. On abdominal examination, four fifthsof the head was palpable . . . [Full text of this article]

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