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
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2
Q

Factors that favour successful VBAC

A
  • uncomplicated pregnancy without other risk factors
  • SROM
  • previous successful VBAC
  • previous successful vaginal delivery
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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
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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
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5
Q

ECV risk

A
Placenta abruptio 
PROM 
Cord accident 
Trans placental hemorrhage 
Fetal bradycardia
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6
Q

Vaginal breech delivery risks

A

Maternal:

  • increased effort
  • emergency C sect

Fetal

  • obstruction: can hypoxia
  • cord prolapse
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7
Q

CI for breech delivery

A

Large/small fetus
Placental insufficiency
Footling breech
Previous C section

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8
Q

ECV success rate and benefits

A

50% success, Reduce number of c sections, low rate of AE

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