Risk Factors for Perinatal Death | Uterine Rupture During Vaginal Birth After Cesarean Section (VBAC)

 

Patient selection:

(1) history of cesarean section

(2) currently attempting vaginal birth

 

Parameters:

(1) history of previous vaginal delivery

(2) use of prostaglandins to induce delivery

(3) number of births at the delivery hospital per year

 

Parameter	Finding	Points
history of previous vaginal delivery	yes	0
	no	1
use of prostaglandins to induce delivery	no	0
	yes	1
annual number of births at hospital	< 3,000	0
	>= 3,000	1

 

number of risk factors for uterine rupture and/or perinatal death =

= SUM(points for all 3 factors)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The greater the number of risk factors the greater the risk of problems.

 

Steps to reduce risk:

(1) Avoid the use of prostaglandins to induce vaginal delivery in a woman with a history of cesarean section.

(2) VBAC is ideally done on an obstetrics ward with a large number of deliveries and adequate facilities to handle obstetrical emergencies.