Travaglio di prova dopo taglio cesareo:quali fattori intervengono nella scelta delle modalità del parto? Due esperienze cliniche milanesi a confronto

The frequency of caesarean section is gradually increased over the years. Women that after a caesarean section decide to endure a pregnancy need to discuss with their gynecologist about the way of delivering. In the first part of the thesis are described the factors that may influence the success or failure of trial of labor, contraindications, advantages, disadvantages, both vaginal birth after caesarean section and elective repeat caesarean section. In the second chapter, I dealt with the principal and most feared risk of trial of labor after a prior caesarean delivery: the uterine rupture. The aim of the thesis have been to evaluate the type of information about mode of delivery that the pregnant women after a previous caesarean section received during a following pregnancy; to highlight the factors that influence this choice; to analyze the opinion of the operators that, every day, have to deal with this topic, and to observe any potential differences between two Hospitals in Milan. To reach the goal it has made: - 48 interviews to women during puerperium at the Clinic “Luigi Mangiagalli” and 11 at the Hospital “Vittore Buzzi”; - 11 questionnaires compiled by midwives in the Clinic “Luigi Mangiagalli” and 14 at the Hospital “Vittore Buzzi”; - 10 questionnaires compiled by doctors of the Clinic “Luigi Mangiagalli” and 10 at the Hospital “Vittore Buzzi”. Finally, it can be stated that the major referrers for women that look for this kind of information are gynecologists, even if sometimes it is not scientific evidence based. Professionals words are able to influence the choice of mode of delivery, influencing satisfaction or dissatisfaction of the women. Another important factor in women choices are the previous experiences of labor and the desire to live the experience of vaginal birth.