Counselling Women about the Caesarean Delivery in Future Pregnancies – PART 2

  • COUNSELLING WOMEN WITH A HISTORY OF 1 OR 2 CD
  • Discuss and document the risks and benefits of trial of labour after caesarean (TOLAC) versus a repeat CD, preferably before 36 weeks of gestation.
  • WHEN TOLAC (TRIAL OF LABOUR AFTER CAESAREAN) IS AN OPTION

  • A review of woman’s complete obstetric history.
  • An assessment of all risks associated with both TOLAC and repeat CD.
  • An individual assessment of the likelihood of successful vaginal birth after caesarean (VBAC).
  • An enquiry into the woman understands of risk and her desire for future pregnancies.
  • A specific plan for delivery including contingencies, for example, management if the woman presents in labour prior to schedule repeat CD. Contraindications to TOLAC
  • Prior classical uterine incision.
  • Previous uterine surgery in which uterine cavity was entered (such as myomectomy).
  • History of more than two previous CDs.
  • Contraindications to vaginal delivery in general (eg; placenta previa or malpresentation). INDICATIONS FOR VAGINAL DELIVERY.Prior successful vaginal deliverySpontaneous labour

 



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