VBAC

Question 1

Contraindications to VBAC

Answer 1

• Previous Classical C/Section
• Two or more previous Caesarean sections
• Patient refusal
• No recourse to emergency Caesarean section
• Very large baby
• Malpresentation or other complication
• Multiple pregnancy
• Placenta praevia

Question 2

Management of VBAC

Answer 2

• labour must be in hospital with facilities for c/s if failure
• IV access
• Foleys urine catheter
• Continuous CTG
• Partogram must be used in order to monitor progress in labour. Good progress must be seen

Question 3

Antenatal management of a VBAC

Answer 3

• Thorough history: Type of incision (classical or lower), indication for c/s,
  elective/emergency, outcome, complications
• Counselled on mode of delivery options

Question 4

signs of uterine rupture

Answer 4

• abnormal pain, especially between contractions
• vaginal bleeding
• Fetal distress
• evidence of hypovolaemic shock
• diminished or altered uterine activity
• haematuria
• alteration in fetal position