Counselling Flashcards
1
Q
Contraindications to VBAC
A
- previous uterine rupture
- classical csection scar
- 3 or more previous c section
- previous uterine surgery
- other absolute CI to vag birth like major placenta previa
2
Q
Factors that favour successful VBAC
A
- uncomplicated pregnancy without other risk factors
- SROM
- previous successful VBAC
- previous successful vaginal delivery
3
Q
Risks of VBAC
A
- possibility of emergency CS if it fails
- risk of pelvic floor trauma
- risk of uterine rupture :1 in 200 and therefore risk of HIE
- risk of stillbirth > 39 weeks higher than ERCS
- need to be continuously monitored
4
Q
Risks of ERCS
A
- greater surgical morbidity and longer hospital stay
- lower rates of BF
- small increase in risk of placenta previa, accreta etc
- small increase in risk of pelvic adhesions
- anesthetic and infection risks
- after 2x ERCS, VBAC in future is strongly discouraged
5
Q
ECV risk
A
Placenta abruptio PROM Cord accident Trans placental hemorrhage Fetal bradycardia
6
Q
Vaginal breech delivery risks
A
Maternal:
- increased effort
- emergency C sect
Fetal
- obstruction: can hypoxia
- cord prolapse
7
Q
CI for breech delivery
A
Large/small fetus
Placental insufficiency
Footling breech
Previous C section
8
Q
ECV success rate and benefits
A
50% success, Reduce number of c sections, low rate of AE