VBAC Delivery

Question 1

What’s success rate in previous 2 CS

Answer 1

VBAC successful rate similar if no other risks or contraindications
is 3out 4
Uterine rupture: 1:200
Emergency section 1:4
Offer option of alongside midwifery unit
Risk assessment of emergency transfer from home
Another appointment with consultant

Question 2

Benefits of CS?

Answer 2

1:10 women go in to labour before the date elective CS.
Uterine tear with CS 1:1000
Birth choice clinic
5 out 100 risk of uterine rupture

Question 3

FGRtime of delivery

Answer 3

1- Assessment, surveillances and management to prevent still birth and other complications associated comorbidites
2 it’s important to identify women who are high risk of FGR
In previous & current pregnancy or having suboptimal growth
3- in previous pregnancy the definition of FGR is if there is birth weight less than 3 centile, birth weight less than10 centile, placental dysfunction with delivery less than 34 weeks
FGR in current pregnancy identified as EFW or AC less than 3 rd centile
EFW or AC less than 10 centile with placental dysfunction uterine artery Doppler plustile above 95% centile between 20-24 weeks or umbilical artery Doppler pulstile index above 95centile.
Once we identified women with FGR we look in to other risk factors in the agreed pathway
Low risk : anomaly scan ,SFH
Moderate anomaly scan equal or less than 10 centile 32 week scan and every 4 weeks until delivery .
in high risk do uterine artery if normal do scan at 32 weeks
If ubnormal and EFW 10 or above we do scan from 28 week and every 2 weeks
If EFW less than 10 centile discuss with FM team