vaginal birth after cesarean(English)

• historically, women who underwent a cesarean section were thought to be limited to cesarean section delivery in all future pregnancies. A 1996 study concluded that even though the absolute risk was low, the relative risk of major maternal complications (hysterectomy, uterine rupture, or operative injury) were significantly increased in women having a trial of labor after previous cesarean section compared to women electing to have a repeat cesarean section without labor. Risk factors associated with uterine rupture include single layer closure of the uterus, an inter-delivery interval of less than 2 years and prolonged labor or dystocia. An inverse relationship has also been noted between the thickness of the uterine scar at 37 weeks gestation and the risk of subsequent dehiscence or full rupture. A scar thickness of less than 2.3 mm as measured by ultrasound was associated with a higher risk of uterine rupture. A 2010 conference concluded that: ‘trial of labor is a reasonable option for many pregnant women with one prior low transverse uterine incision’. Subsequently, ACOG revised their guidelines in an attempt to be less restrictive
• ACOG, CS, TOLAC
• Obstetrics, Risk factor
• https://doi.org…84978-6.00022-4
• https://doi.org…2884-019-2334-3