VBAC

Question 1

Who should be offered a VBAC?

Answer 1

Women with an uncomplicated pregnancy at term

Question 2

What must all women with a previous LSCS have antenatally?

Answer 2

A USS to confirm placental site

Question 3

What antenatal care should be given?

Answer 3

• Referall to obstetrician
• Info leaflet given
• Decision should be made at 36/40 with clear plan

Question 4

What % of women will have a successful VBAC?

Answer 4

72-75%

Question 5

What are the possible reasons for a previous CS?

Answer 5

• Foetal distress
• Breech
• Placenta praevia
• Multiple pregnancy
• 2+ previous CS
• Elective

Question 6

What risks are not increased with VBAC?

Answer 6

• Thromboembolism
• Hysterectomy
• Maternal death
• Anaesthetic complications

Question 7

What does have a VBAC reduce the risk of?

Answer 7

• RDS

- Complications in future pregnancies

Question 8

What intrapartum care should be given?

Answer 8

• Cannula and bloods
• Awareness of scar tenderness
• Continuous CTG
• Bladder care
• Timely observations

Question 9

Give 7 indicators of scar rupture

Answer 9

1. Abnormal CTG
2. Severe constant abdominal pain
3. Acute scar tenderness
4. Abnormal PV bleeding/ haematuria
5. Cessation of previously efficient contractions
6. Signs of shock
7. Loss of station

Question 10

What is the risk of uterine rupture according to RCOG (2015)?

Answer 10

1 in 200

Question 11

How does an induction/augmentation affect the possibility of VBAC?

Answer 11

• Increased risk of uterine rupture
• Increased risk of CS
• Advised not to exceed 8 hours of augmentation

Question 12

What are the contraindications for a VBAC according to RCOG (2015)?

Answer 12

• Previous uterine rupture

- Classical caesarean scar