VBAC

Question 1

What are the five contraindications to VBAC?

Answer 1

1. Previous Classical cesarean
2. Previous inverted-T incision.
3. Previous uterine rupture.
4. Previous major uterine reconstruction (e.g., full-thickness repair for myomectomy, repair of Mullerian anomaly, cornual resection)
5. Patient requests ERCS vs VBAC.

Question 2

List six factors which which increase the success of VBAC.

Answer 2

-Non-recurring indication for the first C/S – 80% chance
-Previous vaginal delivery
-Previous successful VBAC
-Spontaneous labor/favorable cervix
-BMI<30
-Maternal age <30.
-No medical co-morbidities

Question 3

List six factor which decrease the success of VBAC.

Answer 3

-Induction of labor with unfavorable cervix
Augmentation
-Previous C-section for “CPD”
-Post-dates
-Suspected macrosomia (EFW >4000g) – 60% chance
-BMI>30
-Medical comorbidities
-Age>35