Flashcards in 13 - Obs - Labour - Vaginal Delivery after previous C-section (VBAC) Deck (5):
Inc usual absolute contraindications for c section, a ? uterine ? and ? prev c secs. After ? c secs, vaginal delivery seldom attempted in ??.
Factors influencing Vaginal Delivery after 1 C section
Prediction of success: If vaginal deliv attempted, ?-?% women will deliv, others req ? c section in ?. Prediction of success not ?.
Factors incr success: ? labour, inter preg interval less than ?, low ? and ?, ?, prev ? deliv (90% chance) and when prev c section was done ?/for fetal ?. ? subsequent fetus and engagement of head are ? prognostic features.
Maternal risks of VBAC
Related to chance of ? deliv – vaginal deliv is ?, emergency c sec ? safe, elective in between. So when attempting VBAC maternal safety depends on chance of ? delivery. Risk of ? and uterine ? higher w VBAC. Serious maternal morb greater w ? ? of prior c secs, risk of placenta ?.
Fetal Risks of VBAC
Risk incr (3-10x) w VBAC. Largely as ? c sec at ?wks eliminates risk of antepartum ? beyond that time. Risk of VBAC itself is ?, usual rare risks of labour and ? of old uterine ?. Occurs in 0.7% VBAC attempts, approx. 10% perinatal mort. Risk higher w ? VBAC (emergency c sec) and if ??s/oxytocin used. Risk of stillbirth related to VBAC is ?. ? ? ? more common w elective c sec. Fetal morb incr w incr no of ? ??
Transient tachypnoea of the newborn TTN