VBAC + Breech Flashcards
Give 2 complications of Vaginal birth after caesarean section (VBAC)
Uterine rupture
Scar dehisence
Give 4 risks increasing the likelihood of VBAC complications
Upper segment ceasarean section
Previous uterine rupture
Macrosomia
Breech
Vasa praevia
Give 2 indications for upper segment caeserean section
Placenta previa
Anatomical distortion of uterus
Preterm caesarean
Give 4 complications of elective caesarean section
Injury to bowel + bladder
Bleeding (+possible need for transfusions or hysterectomy)
Infection
Thrombosis (DVT/PE) likelihood increases
Adhesions
Injury to baby + TTN
What is the intrapartum care provided for VBAC
Abdominal palpation on admission / onset of labour
Intravenous access + FBC, G&S
Continuous electronic fetal heart rate monitoring
Epidural anaesthesia is NOT contraindicated
“Routine” observations in labour as per Intrapartum care guidelines unless otherwise requested
What are the symptoms/signs of wound dehiscence / uterine rupture in VBAC?
Abnormal CTG
Cessation of previously efficient uterine activity
Pain:
o Severe Abdominal Pain between contractions
o Breakthrough pain with epidural in place
o Chest pain or Shoulder tip pain, sudden onset of shortness of breath
o Acute onset scar TENDERNESS
Vaginal bleeding + Blood in urine (haematuria)
o Maternal tachycardia, hypotension, or shock
Loss of station or presenting part
Give 5 risk factors for Breech presentation
Polyhydramnios (baby spins round more)
Neuromuscular disorder (baby doesnt move as much)
Macrosomia (baby too big to move)
Uterine fibroids (obstructs cavity)
Uterine septum (obstructs cavity)
Placenta praevia (obstructs cavity)
Multiple pregancny
Prematurity (1 in 3 pre-term babies are Breech)
Give 3 types of breech presentation
Complete
Footing
Frank
What is the management for breech presentation?
External cephalic version (ECV)
Vaginal breech birth
Caesarean section
Give 4 risks associated with Vaginal Breech Birth
Cord prolapse
Trapped aftercoming head
Intracranial haemorrhage
Internal injuries
