Volume 121, Issue 2 p. 157-162
Review Article

Intrapartum management of trial of labour after caesarean delivery: evidence and experience

JR Scott

Corresponding Author

JR Scott

Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City, UT, USA

Correspondence: Prof. JR Scott, Department of Obstetrics and Gynecology, University of Utah Medical Center, 50 N. Medical Drive, Salt Lake, UT 84132, USA. Email [email protected]Search for more papers by this author
First published: 16 September 2013
Citations: 34

Abstract

Few studies have focused specifically on the intrapartum management of patients following a prior caesarean delivery. Contemporary assessments and recommendations on attempting vaginal birth after caesarean delivery (VBAC) vary. The actual conduct of labour and delivery of the infant in an uncomplicated trial of labour after caesarean (TOLAC) is similar to the management of a patient without a previous caesarean. Intrapartum management of TOLAC differs primarily in the need for caution with induction of labour in women with an unfavourable cervix, the avoidance of overstimulation with oxytocin augmentation, and surveillance for prompt recognition of the rare case of uterine rupture.