1
Q
Contraindications to VBAC
A
- Previous Classical C/Section
- Two or more previous Caesarean sections
- Patient refusal
- No recourse to emergency Caesarean section
- Very large baby
- Malpresentation or other complication
- Multiple pregnancy
- Placenta praevia
2
Q
Management of VBAC
A
- labour must be in hospital with facilities for c/s if failure
- IV access
- Foleys urine catheter
- Continuous CTG
- Partogram must be used in order to monitor progress in labour. Good progress must be seen
3
Q
Antenatal management of a VBAC
A
- Thorough history: Type of incision (classical or lower), indication for c/s,
elective/emergency, outcome, complications - Counselled on mode of delivery options
4
Q
signs of uterine rupture
A
- abnormal pain, especially between contractions
- vaginal bleeding
- Fetal distress
- evidence of hypovolaemic shock
- diminished or altered uterine activity
- haematuria
- alteration in fetal position
