vaginal delivery post c-section (VBAC)

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Last updated 12:41 PM on 9/24/26
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13 Terms

1
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Define VBAC

A vaginal delivery after C-section

2
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Define TOLAC

Trial of labour after C-section

3
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What are the maternal benefits of VBAC?(5)

  1. Avoids risk of surgery

  2. Decreases maternal haemorrhage

  3. Faster recovery & hospital stay

  4. Improved bonding and breastfeeding

  5. Higher success for future VBAC


4
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What are the fetal benefits of VBAC?(2)

  1. VBAC have a lower risk of initial respiratory morbidity (TTOTN)

  2. Lower risk of perinatal deaths


5
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What are the maternal prerequisites of a VBAC? (4)

  1. BMI <40

  2. Interval pregnancy +18 months

  3. 1 previous C-section (no classical / T shaped scar)

  4. Absence of obstetric indications for C/S


6
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What are the fetal prerequisites of a VBAC? (3)

  1. Estimated fetal weight <3500 g

  2. Singleton

  3. Cephalic presentation


7
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What is the predicting VBAC success rate?

60-88%

8
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What are the facility & resource requirements for VBAC?(3)

  1. Hospital equipped with 24-hour emergency theatre facilities

  2. Continuous intrapartum monitoring capabilities

  3. Staff ready to perform an immediate C-section and advanced neonatal resuscitation


9
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Which IV solutions should be administered during intrapartum care? (2)

  1. IV drip NaCl 0.9% or

  2. Ringer’s lactate at 80-120 mL/ hour


10
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What is the intrapartum care checklist for a VBAC? (5)

  1. CTG monitoring (soon as uterine contractions start)

  2. IV access

  3. Blood should be ready

  4. Urinary catheter

  5. Pain relief epidural analgesia


11
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What are the primary warning signs of a uterine rupture? (5)

  1. Abnormal fetal heart rate (most consistent finding)

  2. Abdominal pain > severe and persistent between contractions / acute tenderness

  3. Sudden cessation of uterine contractions

  4. Bleeding

  5. Maternal tachycardia/ hypotension


12
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What is the classical triad of a complete uterine rupture?

  1. Pain

  2. Vaginal bleeding

  3. FHR abnormalities


13
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What are the immediate resuscitations for a uterine rupture?(3)

  1. Secure access & fluids (IV fluids)

  2. Bloods > U&E, FBC, PTT

  3. Blood products > 4 red cell concentrations, 4 fresh frozen plasma, 1 adult dose of platelets