Planning Birth After A Previous Cesarean Delivery:
It is important to have a discussion with your obstetrician about your chances of having a vaginal birth after a previous cesarean section. The success rates of vaginal birth post a cesarean delivery are between 60-80%, with women who have had a prior vaginal delivery having the highest rates of success (85-90%). The incidence of cesarean scar rupture is as low as 0.5% during a subsequent vaginal birth.
Higher Rates Of Scar Rupture:
1. Women who have conceived within a short span of time post cesarean birth
2. Older women (>40years)
3. Obesity
4. Women carrying a heavy baby
5. Pregnancy that has continued beyond the due dates
6. Thin scar on ultrasound
7. Induction of labour: Women who go into labour spontaneously have a lower chance of scar rupture and better success at vaginal birth as opposed to women in whom labour is induced or augmented
8. Previous uterine surgeries
9. Extension of uterine incision in the previous cesarean section: Doctores often ask the patient for her previous surgical records to know if there were any difficulties faced or extensions in the uterine scar during the operation, as this may influence our decision for planning a vaginal birth.
A detailed discussion with your doctor about the benefits of vaginal birth over a cesarean section at the first visit; evaluation of your previous records and the presence or absence of current obstetric/ medical complications will determine if you are an ideal candidate for a vaginal delivery. A vaginal delivery post a cesarean section requires continuous monitoring of the mother and fetus and has to take place by an experienced Obstetrician for optimal results.
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