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Re: VBAC, Three previous CS. From: Robert J. Carpenter, Jr., M.D. (zygote@icsi.net) Sun Jan 30 11:26:15 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joe Cutchin: "Re: Vaginal Delivery of twins" Previous message: K Dew: "Vaginal Delivery of twins" In reply to: Luis Sanchez-Ramos: "Re: VBAC, Three previous CS." Next in thread: Efrain Ramirez: "Re: VBAC, Three previous CS." Date sent: Sat, 29 Jan 2000 19:35:10 -0600 Send reply to: ob-gyn-l@obgyn.net From: luis.sanchez@jax.ufl.edu (Luis Sanchez-Ramos) To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> Subject: Re: VBAC, Three previous CS. The article is Leung, Leung, Paul, should be 10/93 in the AJOG. > At Sat, 29 Jan 2000, Robert J. Carpenter, Jr. MD wrote: > >>Since I would not/do not labor 3 prior c-sections<< > > >> post conclusion of the pregnancy, let us know the outcome<< > > During the years 1990 & 1991 our cesarean rate (with over 5000 > deliveries at a tertiary center)was 8.5 and 8.1%. A major contributor > to our reduced cesarean rate was a policy of "mandatory trial of labor" > for all patients with prior cesareans (except for those with classical > scars). Several patients with >2 prior cesareans delivered without any > problems. If I remember correctly, we even had a patient with 5 prior > cesarean who had a VBAC. There are data in the literature of TOLs in > patients with more than 1 prior cesarean. I'm not advocating a trial of > labor for this particular patient. I'm just surprised to the reaction > when the lister suggested she may desire a trial of labor. I'm not sure > of the uterine rupture rate for patients with more than 1 prior > cesarean: I would have to look it up. Nonetheless, the rate quoted from > USC seems high. Many patients at USC had a trial of labor with > "unknown" scars, many of which were classical cesarean operations > performed in Latin America. > > LSR > Robert J. Carpenter, Jr., M.D. St. Luke's Medical Tower # 2720 6624 Fannin, Houston, TX 77030 zygote@icsi.net 713-795-4600 FAX:713-795-4422 Next message: Joe Cutchin: "Re: Vaginal Delivery of twins" Previous message: K Dew: "Vaginal Delivery of twins" In reply to: Luis Sanchez-Ramos: "Re: VBAC, Three previous CS." Next in thread: Efrain Ramirez: "Re: VBAC, Three previous CS."

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