Suitability for VBAC

Question 1

Which women are best suited for VBAC?

Answer 1

Most women with 1 previous C/S
Singleton pregnancy
Cephalic presentation
Review old op notes

Question 2

What are contraindication for VBAC?

Answer 2

Previous classical scar
Previous uterine rupture (5% recurrence risk)
All other absolute contraindications for vaginal delivery
J or T incisions need to be decided case by case
Previous myomectomy should be treated as VBAC

Question 3

Previous x2 C/S or more and VBAC

Answer 3

Risk of uterine rupture more or less the same
68/10000 vs 92/10000
More than half of women with 2 previous C/S have delivered vaginally before and 40% have already had VBAC
Success rate 71%
Risk of uterine rupture 1.36%
Risk of blood transfusion 1.99% vs 1.21%
Risk of hysterectomy 56/10000 vs 19/10000

Question 4

What are the factors that increase the risk of uterine rupture?

Answer 4

Short interval between pregnancies (