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VAGINAL BIRTH AFTER CAESAREAN

SECTION ( TRIAL OF SCAR)

AGNES P MADUKA (INTERN DOCTOR)

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OBJECTIVES

DEFINITION

PRE REQUISITIES FOR VBAC

CONTRAINDICATION

MANAGEMENT OF LABOUR ANDDELIVERY FOR VBAC

BENEFITS OF VBAC

COMPLICATIONS OF VBAC FOLLOW UP

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DEFINITION

Giving !"#gnn$ %&'n n &!!&"$ni$ &*vgin+ ,i"$- *$#" !"#vi&. /#."#n .#/$i&n &"n #0$#n.iv# '&'#/$&'

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PRE REQUISITIES FORVBAC In*&"'#1 /&n.#n$ &* $-# %&'n

Sing+#$&n !"#gnn/ %i$- /#!-+i/ !"#.#n$$i&nn1 +&ngi$1in+ +i# 2

Avi+,i+i$ &* "#.&"/#. *&" #'#"g#n/ /#."#n

.#/$i&n %i$-in 34 'in$#. &* 1#/i.i&n2 On# !"#vi&. +&%#" .#g'#n$ $"n.v#".# ./"

A1#5$# '$#"n+ !#+vi.2

C&n$in&. '&ni$&"ing &* +,&" 2

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CONTRAINDICATION FOR VBAC

P$i#n$ "#*.+ *&" VBAC P"#vi&. /+..i/+ &" inv#"$#1 6T7 .-!#1

$#"in# in/i.i&n

P"#vi&. $%& &" '&"# +&%#" .#g'#n$

/#."#n .#/$i&n

P#+vi. /&n$"/$#1 &" ..!#/$#1 CPD

P"#.#n/# &* &$-#" /&'!+i/$i&n. in

!"#gnn/ O,.$#$"i/ (!"##/+'!.i8'+!"#.#n$$i&n8 !+/#n$ !"#vi) &"'#1i/+

R#.&"/#. +i'i$#1 *&" #'#"g#n/

/#."#n 1#+iv#"

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UNSUCCESSFUL VIBAC

In1/#1 +,&"

N& !"#vi&. vgin+ ,i"$-

VIBAC $ 9: %##;. g#.$$i&n

Bi"$- %#ig-$ g"#$#" $-n 9444g

C#"vi/+ 1i+$i&n &n 1'i..i&n +#.. $-n < /' n1+#.. $-n $%& #". *"&' !"#vi&. / .#/$i&n

A1vn/#1 '$#"n+ g#2

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MANAGEMENT OF LABOR AND DELIVERYFOR VBAC C&n.#+ '&$-#"

R#vi#% $-# &!#"$iv# n&$#.

In1/$i&n %i$- /$&$#/ i. /&n$"in1i/$#12

In1/$i&n &* +,&" %i$- !"&.$g+n1in. in/"#.#. $-#"i.; &* $#"in# ./" "!$"#2

Ag'#n$$i&n %i$- O0$&/in *$#" .!&n$n#&. &n.#$&* +,&" i. !&..i,+# n1#" /+&.# '&ni$&"ing2

(A++ %&'#n n1#"g&ing $"i+ &* ./"8 &,.#"v$i&n &n vgin+,+##1ing8 ./" $#n1#"n#.. n1 /&+&" &* +i5&" i. 1&n# #v#" 34'in$#.2

A..#..'#n$ &* /#"vi/+ 1i+$$i&n8 #=/#'#n$ n1 .$$i&n &* $-#!"#.#n$ing !"$ i. 1&n# #v#" $-"## $& *&" -&".2

M$#"n+ ,+&&1 !"#.."# n1 !+.# "#/&"18 n1 *$+ -#"$ .&n1"#/&"1 "# $;#n #v#" 34 'in$#. in #"+ >".$ .$g# &* +,&" n1:? 'in$#. in .#/&n1 .$g# &* +,&"

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MANAGEMENT OF LABOR AND DELIVERYFOR VBAC

An in$"v#n&. +in# i. /&''#n/#1 %i$-Ring#"7. .&+$i&n2

B+&&1 .'!+# i. .#n$ *&" H,@8 g"&! n1/"&.. '$/-ing2

L,&" '&ni$&"ing/+ini/++ (*&" ./"1#-i./#n/#) n1 #+#/$"&ni/++ *&" *#$+

,#-vi&"2 C"#*+ .#"i+ /+ini/+ ..#..'#n$ i. n##1#1 $& #n."#1#5$# /#"vi/&'#$"i/ !"&g"#.. &* +,&"2

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TERMINATION OF VBAC

T-# $"i+ &* ./" i. $#"'in$#1 i*

/#"vi/+ 1i+$$i&n g"!- .-&%. n 1#vi$i&n $& $-#"ig-$ &* $-# +#"$ +in#8

./" $#n1#"n#..8

n#0!+in#1 '$#"n+ -ig- !+.# "$#

*"#.- vgin+ ,+##1ing2

*$+ 1i.$"#.. ..&/i$#1 %i$- i* $-#"# i. *"#.- $-i/;'#/&n#' .$in#1 +i5&"8 n1 i""#g+" *$+ -#"$,#$. n1&" -#"$ ,#$. &* +#.. $-n :

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BENEFITS FOR VBAC

D#/"#.#1 '$#"n+ '&",i1i$ (in*#/$i&n n1&$-#".)

R#1/#1 +#ng$- &* -&.!i$+ .$

D#/"#.#1 n##1 *&" ,+&&1 $"n.*.i&n

D#/"#.#1 "i.; &* ,n&"'+ !+/#n$$i&n n1n##1 *&" .//#..iv# /#."#n 1#+iv#" in n#0$!"#gnn/

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RISK OF VBAC

Un.//#..*+ $"i+ (

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L.$+8 %# .-&+1 #n/&"g# $"i+ &* ./" $& %&'#n%i$- &n# !"#vi&. +&% .#g'#n$ / .#/$i&n .& . $&"#1/# "$#. &* / .#/$i&n2 An1 / .#/$i&n .-&+1 n&$+%. ,# *&++&%#1 , / .#/$i&n ,$ !$i#n$ '.$

-v# -&.!i$+ 1#+iv#" in %#++ #5i!!#1 -&.!i$+n1 /&'!+i/$i&n .-&+1 ,# 1ign&.#1 $ n #"+.$g# .& $-$ %# /n !"#v#n$ '$#"n+!#"in$+'&"$+i$ n1 '&",i1i$2