Risk of uterine rupture following induction of labour in women with a previous caesarean section in a large UK teaching hospital.

To determine the outcome of induction of labour for women who had had previous caesarean sections, we identified all women who had induction of labour at the Leicester Royal Infirmary between January 1994 and September 2001. During the study period, there were 43,175 deliveries and 8761 inductions of labour (20.3%). Of these, 5047 (57.6%) were induced with prostaglandins and 138 women in this group had a previous caesarean section but eight were excluded from the analysis because of induction for early intrauterine death (five) and late terminations for fetal anomalies (three). The remaining 130 women formed the study group. Induction of labour resulted in spontaneous vaginal delivery in 50% of cases, with 11% requiring instrumental delivery and 39% had caesarean sections. There were no cases of uterine rupture in this series. We conclude that prostaglandins are safe for inducing labour in women with previous caesarean sections, but should be administered with caution.