VBAC Flashcards
1
Q
Success rate of VBAC after one previous section?
A
72-75%
2
Q
Success rate of VBAC in women with a previous vaginal delivery?
A
85-90%
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
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
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
6
Q
What is the first sign of uterine rupture?
A
Abnormal ctg ( 66- 76% of cases)
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
8
Q
Risk of uterine rupture with VBAC
A
0.2- 0.5%
9
Q
VBAC success rate after previous for malpresentation
A
84%
10
Q
VBAC success- prev labour dystocia
A
64%
11
Q
Risk of OASIS with VBAC
A
5%
12
Q
What is the risk of cesarean section with induction- TOLAC
A
1.5 increased risk
13
Q
What is the risk of uterine rupture with induction - TOLAC
A
2-3x increased compared to spontaneous labour
