Population: Pregnant women with a history of one previous cesarean delivery via low-transverse incision.
Organization
ACOG 2019
Recommendations
–Most women with 1 previous cesarean delivery and a low-transverse incision should be counseled about and offered TOLAC.
–In patients who have had a cesarean delivery or major uterine surgery, misoprostol should not be used for cervical ripening.
–Epidural analgesia may be used as a part of TOLAC during labor.
Practice Pearl
• The benefits of a vaginal birth after cesarean (VBAC) include avoiding major abdominal surgery, lower rates of hemorrhage, thromboembolism, infection, and a shorter recovery period. VBAC may also decrease maternal risks associated with cesarean sections, including hysterectomy, bowel/bladder injury, and future abnormal placentation.
Source
–Obstet Gynecol. 2019;133(2):e110-e127.