Objective To explore the success rate and safety of vaginal delivery of scar uterine pregnancy after cesarean section. Methods One hundred and twenty eight pregnant women with scar uterine pregnancy who were admitted to a hospital in Liaoning Province from April 2013 to January 2020 and undergone cesarean section and were suitable for vaginal delivery were selected as the research group. 128 normal pregnant women who underwent cesarean section were selected as control group. The success rate of vaginal delivery

labor time

intrapartum hemorrhage

rate of admission to intensive care unit（NICU）

length of hospitalization

blood transfusion

neonatal score

and postpartum complications of the two groups were compared. Results The success rate of vaginal delivery for pregnant women in the study group was 67.19%

which was lower than 80.47% in the control group. The difference was statistically significant（P

<

0.05）. The time of the first and second stages of labor in the study group was shorter than that of the control group

the difference was statistically significant（P

<

0.05）. The time of the third stage of labor of pregnant women in the study group was longer than that in the control group

but the difference was not statistically significant（P

>

0.05）. The hospitalization time of pregnant women in the study group was longer than that in the control group

and the difference was statistically significant（P

<

0.05）. There was no statistically significant difference in the amount of bleeding

blood transfusion rate and NICU rate of newborns between the two groups（P

>

0.05）.The Apgar score of newborns in the study group was（7.69±1.38） points

slightly higher than the（7.45±0.96） points of the control group

but the difference was not statistically significant（t=1.615

P=0.108）.The incidence of postpartum complications in the study group was 23.44%

which was slightly higher than 21.88% in the control group

but the difference was not statistically significant（χ

2

=0.089

P=0.765）. Conclusion Strictly monitor the labor progress of pregnant women and fetal conditions

supplemented by targeted care

when the pregnant women’s own conditions and various indicators meet the conditions of vaginal delivery

it is safe and feasible to choose vaginal delivery for pregnant women with scarred uterus after cesarean section.