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TOLACTrial of Labor After Cesarean
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Although ACOG reaffirmed the TOLAC opportunity in 2010, a study showed that only 52% of gynecologists offered VBAC in private practice (10,11).
Other possible reasons (not tested in this study) include hospital or insurer restrictions over TOLAC and/or VBAC, physician practice or preferences, or patient preferences.
TOLAC has been practiced individually in our center for decades, but the formal policy of TOLAC was first implemented in the year 2000.
"No evidence suggests that epidural analgesia is a causal risk factor for unsuccessful TOLAC," the authors added.
Descriptive statistics were calculated, followed by the secondary analysis of the suspected maternal and obstetric factors of unsuccessful TOLAC. The comparison of mean age, VBAC, inter-delivery interval, Bishop score, and rate of cervical dilatation was done by significance testing using independent sample t test, taking significance level less than 0.05.
This then allowed us to uniquely develop TOLAC and ERCD groups with well balanced covariates with minimal bias.”
After lengthy discussions, we felt confident in her ability to consent to a trial of labor after c-section (TOLAC); we arranged an obstetrics consult with the interpreters present.
they do specify that an individually constructed emergency management plan should be in place for each woman who attempts a trial of labor after cesarean (TOLAC).
In 1980, the National Institutes of Health concluded that a trial of labor after cesarean (TOLAC) birth was safe for women with previous cesarean births with low transverse uterine scars (7).
Yes, if providers and patients are willing to accept a lower TOLAC rate in women with a measurement <2.5 mm.
Before an attempted vaginal delivery, patients were informed about the risks, benefits, potential complications and alternatives to a Trial of Labour After Caesarean (TOLAC).