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Vaginal Birth after CesareanAka: Trial of Labor after Cesarean, VBAC, TOLAC
- Criteria (ACOG)
- One or two prior low-transverse cesarean sections
- Adequate pelvis for delivery
- No contraindication below
- Physician immediately available during active labor
- Capable of monitoring labor
- Immediate cesarean delivery available
- Contraindications
- Prior classic or T-shaped incision
- Prior transfundal uterine surgery
- Uterine scar other than low-transverse cesarean scar
- Contracted pelvis
- Medical or obstetric complications preclude VBAC
- Criteria above not met
- Precautions
- Cervical Ripening agents have higher risk of rupture
- Contraindicated in VBAC patients
- Cervical Ripening agents have higher risk of rupture
- Complications (VBAC considered to be relatively safe)
- Uterine Rupture (38 per 10,000 trials of labor)
- See Uterine Rupture for risks
- Perinatal death (1.4 per 10,000 trials of labor)
- Hysterectomy (3.4 per 10,000 trials of labor)
- References
- Uterine Rupture (38 per 10,000 trials of labor)
- References
Vaginal Birth after Cesarean (C0080301) | |
|---|---|
| Definition (MSH) | Delivery of an infant through the vagina in a female who has had a prior cesarean section. |
| Concepts | Therapeutic or Preventive Procedure (T061) |
| MSH | D016064 |
| English | Vaginal Birth after Cesarean, Vaginal Birth after Cesareans, Vaginal Births after Cesarean, VBAC |
| Parent Concepts | Obstetric Delivery (C0011209) |
| Sources | COSTAR, MSH Derived from the NIH UMLS (Unified Medical Language System) |
