Vbac2

Trial of labour after C.section/ VBAC

1. VBAC / TOLAC

2. VBAC – Vaginal Birth after Cesarean TOLAC – Trial Of Labour after Cesarean

3. What’s special about this lady with pr .CS Scar on the uterus Integrity Withstanding pregnancy( classical ) & more so labour (LSCS)

4. Integrity of uterine scar

5. Complications of VBAC Uterine rupture Uterine dehiscence Hysterectomy Thromboembolic disease Blood & Blood product transfusion reactions Maternal Death

6. Complications to the Fetus Antepartum stillbirth Intrapartum still birth Term HIE Term neonatal death

7. Prerequisites for VBAC 1 pr .LSCS only Informed double consent Power - Spontaneous onset of labour Passage - Pelvis – adequate Passenger -Longitudinal lie with cephalic presentation with vertex as presenting part No medical / surgical disorders complicating pregnancy Team ready Blood & blood products availability

8. Scar Dehiscence & Rupture

9. Complete rupture – all the layers involved Incomplete rupture / Scar Dehiscence – only the muscle layer involved with intact visceral peritoneum

10. Features os scar dehiscence