Curiosity has gotten the better of me. When attempting another labour after a successful vbac are the same 'precautions' in place e.g. continuous EFM, bloodwork, cannula etc or is it consider a regular labour given that you have already 'proven' yourself?
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Dr David
Moderator posted 12 December 2000 08:10 PM
Leah
Prior vaginal birth enhances the probability of successful VBAC. (Ref include Phelan JP. Am J Obstet Gynecol 1987;157:1510-5, Lovell R. Aust NZ J Obstet Gynaecol 1996;36:4-8.)
I have no data on whether the risk of uterine rupture in attempted VBAC is affected by previous vaginal birth. Changes in the heartrate pattern seen with EFM is said to give the most reliable early sign of uterine rupture. Bloodwork and cannula are done to prevent delay if rupture occurs. A discussion of the merits or disadvantages of these interventions should form part of the birthplan and discussion prior to VBAC.
Dr.David
DISCLAIMER:
This advice is of a general nature to help in decision-making. It
does not constitute recommended treatment for an individual. You must
consult your health care provider for individual
advice.
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Dr David's 2nd Response -
Moderator posted 19 December 2000 05:44 PM
Leah
A recent study has addressed the question of risk of uterine rupture after successful VBAC.
Effect of previous vaginal delivery on the risk of uterine rupture during a subsequent trial of labour. AmJOG Nov2000;183(5):1184-86.
Of 3783 women with one prior scar, 1021 also had at least one prior vaginal delivery. During a subsequent labour, uterine rupture rate was 1.1% among those without prior vaginal birth, and only 0.2% among those with prior vaginal birth.
Dr.David
DISCLAIMER:
This advice is of a general nature to help in decision-making. It
does not constitute recommended treatment for an individual. You must
consult your health care provider for individual
advice.