VBAC Flashcards

1
Q

Success rate of VBAC after one previous section?

A

72-75%

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2
Q

Success rate of VBAC in women with a previous vaginal delivery?

A

85-90%

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3
Q

Factors that decrease the likelihood of success of VBAC? (7)

A
  • no previous vaginal birth
  • BMI >30
  • AMA
  • pregnancy interval >10 years
  • dystocia previous indication
  • EFW >4kg
  • induction of labour
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4
Q

Benefits of VBAC(4)

A
  • reduction in neonatal respiratory issues (2-3% vs 4-5%)
  • less maternal fever
  • decreased risk of maternal death( 4 vs 13 : 100000
  • increased future vaginal births
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5
Q

Benefits of ERCS (4)

A
  • decreased risk of uterine rupture ( 0.02 vs 0.5%)
  • decreased risk of fetal trauma(0 vs .8hie .4death)
  • less risk of pph requiring transfusion ( 10 vs 17 : 1000)
  • less peripartum endometritis ( 15 vs 29: 1000)…compared to emergency section for failed tolac
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6
Q

What is the first sign of uterine rupture?

A

Abnormal ctg ( 66- 76% of cases)

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7
Q

Other signs of uterine rupture (9)

A
  • severe abdominal pain between contractions
  • chest or shoulder tip pain
  • acute scar tenderness
  • vaginal bleeding or haematuria
  • cessation of uterine contractions
  • maternal tachycardia and hypotension
  • loss of fetal station
  • change in contour of abdomen
  • inability to detect fetal heart at previous location
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8
Q

Risk of uterine rupture with VBAC

A

0.2- 0.5%

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9
Q

VBAC success rate after previous for malpresentation

A

84%

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10
Q

VBAC success- prev labour dystocia

A

64%

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11
Q

Risk of OASIS with VBAC

A

5%

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12
Q

What is the risk of cesarean section with induction- TOLAC

A

1.5 increased risk

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13
Q

What is the risk of uterine rupture with induction - TOLAC

A

2-3x increased compared to spontaneous labour

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