The management of a patient who becomes pregnant subsequent to a cesarean section has been a matter of controversy for over a generation. "Once a cesarean, always a cesarean" is a dictum adhered to by many obstetricians, while another group believes that in certain circumstances it is not only possible but also advantageous to allow such women to be delivered vaginally.1
The principal point of contention between these two divergent groups rests in the estimate of the possible danger of rupture of the uterus and the possibility of calamitous results to both the mother and the baby if such rupture does occur. It is further noted by those who subscribe to the aforementioned dictum that cesarean section is now so safe that no one has the right to deprive the mother and her baby of the surety of the avoidance of rupture of the uterus by withholding the operation.
Cosgrove RA. MANAGEMENT OF PREGNANCY AND DELIVERY FOLLOWING CESAREAN SECTION. JAMA. 1951;145(12):884–888. doi:10.1001/jama.1951.02920300024005
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