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December 23, 1961

Once a Cesarean, Always a Cesarean?

JAMA. 1961;178(12):1128-1131. doi:10.1001/jama.1961.03040510004002

During the past several years much attention has been focused on the essentiality of repeat cesarean section. Currently, there are many who believe that subsequent vaginal deliveries are safe and satisfactory when the indication for the previous cesarean section was a temporary condition. The proponents of this principle gain support from the increased incidence of prematurity in many series of repeat elective cesarean section. If, however, certain criteria are met in establishing date of operation, this undesirable factor can be avoided. In a review of 215 cases of repeated cesarean section, the corrected prematurity rate was 0.4%. Repeat cesarean section is still the treatment of choice when adequate professional coverage and proper physical facilities are not always available.