Endoscopic assessment of the integrity of the postcesarean uterine wall before a trial of labor

Endoscopic examination of the uterine scar site was performed on 52 women prior to a trial of labor after a previous cesarean section. A sterilized intraoperative fiberscope was introduced into the amniotic cavity after rupture of the fetal membranes under constant visual guidance. In 45 cases the site of the previous incision appeared unremarkable, and a scar from the previous surgery could not be identified 'Compromised' scars were detected in three patients, and scars were identified as vertical in four patients with no record of the type of uterine incision used for the previous surgery. Endoscopic data were confirmed postpartum in all cases. This approach seems beneficial in selected cases.