Journal
JOURNAL OF MIDWIFERY & WOMENS HEALTH
Volume 48, Issue 4, Pages 249-257Publisher
WILEY
DOI: 10.1016/S1526-9523(03)00088-6
Keywords
vaginal birth after cesarean; VBAC; trial of labor; uterine rupture; risk factors; fetal heart rate; neonatal outcome
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For the woman with a prior uterine scar, neither repeat elective cesarean birth nor vaginal birth after cesarean birth (VBAC) trial of labor (TOL) is risk-free. When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth. However, when VBAC-TOL fails due to uterine rupture, severe consequences often ensue. The challenge for clinicians today is to provide women who desire TOL after cesarean birth, a more individualized risk assessment of uterine rupture, thereby enhancing success and optimizing outcome. This article examines major risk factors for uterine rupture during VBAC-TOL. In addition, fetal response to uterine rupture and neonatal outcomes are reviewed. (C) 2003 by the American College of Nurse-Midwives.
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