It is possible vaginal birth after a cesarean?

Counseling of patients about to attempt delivery after caesarean section and vaginal documented success after two previous births by cesarean section, means, in essence, establish the principles of informed consent and evidence-based medicine.

Informed consent means that the risks and benefits of vaginal birth after caesarean section there and discussed with her husband. This principle of informed consent requires that the gynecologist know and understand the scientific evidence for the time of delivery. Consequently, it is important that counseling would present the evidence clearly, always remembering that most women will respect the advice of your doctor.

The success rate of vaginal birth after two cesarean deliveries to more than 60% even in pregnant women who have undergone pelvic disproportion cesarean. An analysis of studies of labor following cesarean section for pelvic disproportion, suggests that this is not a recurrent phenomenon, and some of the children born vaginally were larger than their siblings, born by Caesarean section previously.

There is no conclusive evidence that women who have had two cesarean deliveries presented a higher rate of uterine scar rupture during labor compared with those that have undergone a Caesarean section.

Symptomatic uterine rupture occurs in either of two situations in less than 0.5% of patients.

Studies have repeatedly shown that epidural anesthesia is safer during the attempted delivery after a previous cesarean section and abdominal pain is not a reliable sign of uterine rupture. The most reliable signs and symptoms of this are: the decrease in fetal heart rate, elevated maternal pulse and vaginal bleeding.

At present, the contraindication for vaginal birth after cesarean section is previous uterine incision vertically (also called classical) At present, the data to determine the risks and benefits of vaginal birth after cesarean are insufficient or twin gestations more, breech presentation and the presence of a large fetus of a mother who is diabetic.

 

 

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