Evaluating professional society guidelines on vaginal birth after cesarean.
The objective was to compare national guidelines regarding vaginal birth after cesarean. Along with the American College of Obstetricians and Gynecologists practice bulletin, guidelines from the Royal College of Obstetricians and Gynaecologists and the Society of Obstetricians and Gynecologists of Canada were reviewed and compared. Although the 3 organizations agree on most of the risk factors for uterine rupture and failed vaginal birth after cesarean (VBAC), there were some variances in the recommendations to women with 2 previous cesareans and those who required oxytocin augmentation. A disagreement was also present in regard to the availability and requirement of resources to allow a trial of labor after a previous cesarean. Although concerns could be raised about how the literature is synthesized, the 3 organizations recognized the potential biases in published reports and the lack of randomized trials.
Bujold
Emmanuel
E
Department of Obstetrics & Gynaecology, Faculty of Medicine, Centre de recherche du Centre Hospitalier universitaire de Québec (CRCHUQ), Université Laval, Quebec, QC, Canada. emmanuel.bujold@crchul.ulaval.ca
D002170:Canada; D017604:Cesarean Section, Repeat / Q000009:adverse effects; D005260:Female; D005320:Fetal Macrosomia; D005323:Fetal Monitoring; D006801:Humans; D007751:Labor, Induced; D010121:Oxytocin / Q000008:administration & dosage; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors; D012955:Societies, Medical; D017211:Treatment Failure; D014219:Trial of Labor; D014427:Twins; D014597:Uterine Rupture; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects
D010121:Oxytocin