- December 9, 2015
- Posted by: emobile
- Category: Trending Issues
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- 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
