Consent C/S, C/S praevia and instrumental

Question 1

What is the risk of 3rd/4th tears
i) ELCS
ii) Vaginal delivery

Answer 1

i) ELCS 0%
ii) Vaginal delivery 560/100,000 (1/179)

(high is assisted vaginal delivery)

Question 2

Risk of urinary incontinence >1 year after birth
i) ELCS
ii) Vaginal delivery

Answer 2

i) ELCS 1/4
ii) Vaginal delivery 1/2

Question 3

Risk of faecal incontinence >1 year after birth
i) ELCS
ii) Vaginal delivery

Answer 3

i) ELCS 1/13
ii) Vaginal delivery 1/7

No difference with AVD

Question 4

Risk urinary tract injury
i) ELCS
ii) Vaginal delivery

Answer 4

i) ELCS 1/1000
ii) Vaginal delivery 0/1000

Question 5

Average hospital stay
i) ELCS
ii) Vaginal delivery

Answer 5

i) ELCS 4 days
ii) Vaginal delivery 2.5 days

Question 6

Risk uterine rupture in future pregnancies
i) ELCS
ii) Vaginal delivery

Answer 6

i) ELCS 1/98
ii) Vaginal delivery 1/2500

Risk higher after multiple CS and after emergency vs ELCS

Question 7

Risk hysterectomy
i) ELCS
ii) Vaginal delivery
iii) Praevia CS
iv) praevia CS and previous CS
v) CS for accreta

Answer 7

i) ELCS 1/670 150/10,000
ii) Vaginal delivery 1/1250 80/10,000
iii) Praevia CS 11/100
iv) Praevia CS and prv CS 27/100
v) highly likely

Question 8

Risk placenta accreta spectrum
i) ELCS
ii) Vaginal delivery

Answer 8

i) ELCS 1/1000, 100/10,000
ii) Vaginal delivery 1/2500, 40/10,000

Question 9

Risk maternal death (within 6 weeks)
i) ELCS
ii) Vaginal delivery

Answer 9

i) ELCS 1 in 4200 (24/100,000)
ii) Vaginal delivery 1 in 25000 (4/100,000)

Question 10

Risk skin laceration
i) ELCS
ii) Vaginal delivery

Answer 10

i) ELCS 1-2/100
ii) Vaginal delivery 10/100 if ASD

Question 11

Risk childhood obesity
i) ELCS
ii) Vaginal delivery

Answer 11

i) ELCS 1/22
ii) Vaginal delivery 1/25

Question 12

Risk asthma
i) ELCS
ii) Vaginal delivery

Answer 12

i) ELCS 1/55
ii) Vaginal delivery 1/67

Question 13

Risk neonatal mortality (within 28 days
i) ELCS
ii) Vaginal delivery

Answer 13

i) ELCS 1/2000
ii) Vaginal delivery 1/3300

Question 14

CS for placenta praevia
Risk of emergency hysterectomy

Answer 14

11/100

Question 15

CS for praevia
i) risk for further laparotomy during recovery of CS

Answer 15

75/1000

Question 16

CS for praevia
i) risk VTE disease

Answer 16

3/100

Question 17

CS for praevia
i) risk bladder/ureteric injury

Answer 17

6/100

Question 18

CS for praevia
i) risk future placenta praevia

Answer 18

23/1000

Question 19

CS for praevia
i) risk MOH

Answer 19

21/100

Question 20

CS for praevia
i) risk stillbirth in future pregnancies

Answer 20

1-4/1000

Question 21

What conditions make risk of failed instrumental higher?

Answer 21

High BMI
USS >4kg
OP
Mid cavity delivery, 1/5th palpable

Question 22

cc

Answer 22

cc