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Re: Cesarean Rates in South FloridaFrom: Luis Sanchez-Ramos (sanchez-ramos@worldnet.att.net)Wed Dec 31 13:03:38 1997
At Wed, 31 Dec 1997, Geffrey H. Klein, MD wrote: > >"We have a 42 y/o G6P5 with 5 prior cesareans. Four are documented low >transverse. We couldn't document one one them. They were all for CPD at >term, so we figured it must have been a low transverse incision.. Anyway, >she is 42 weeks and the baby might be a little big.. Well, it scans to >4300g. Oh, forgot to tell you, she is breech. We convinced her she >should get a trial of labor. Well, have a nice day. I am going home to >bed.." > >According to the short history given, this patient had 4 attempted VBACs ("all were for CPD at term"). If this fetus had an estimated fetal weight between 2000-3800 gm and met all the other criteria for selective vaginal breech delivery (non-hyperextended fetal head, frank or complete breech, normal pelvimetry, and an experienced Obstetrician) I might consider a TOL since she has had other TOLs. I would like to know the birth weight of the previous 5 children first. No one knowns what the number of previous cesarean is that precludes a trial of labor. Not enough data. Anecdotally, we have had VBACs in patients with several previous cesareans. > >Luis Sanchez-Ramos, MD> >
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