Cesarean delivery: The Daily PANCE Blueprint

Home Cesarean delivery: The Daily PANCE Blueprint

Cesarean delivery: The Daily PANCE Blueprint

A 31-year-old female (G2P1) at 32 weeks gestation presents to the clinic for a routine prenatal visit. In your notes, you have listed that her first child was born via cesarean delivery. On exam, you note a vertical midline scar across her abdomen. The US demonstrates the fetus in a breech presentation. The patient asks you if she can have a vaginal delivery for this baby. What is the best response?

A. Since you have a previous classical cesarean incision, I recommend a repeat cesarean delivery.
B. Fetuses usually convert to cephalic presentation after 37 weeks, and so we can try a vaginal delivery.
C. We can attempt a trial of labor if you want without any risk to you or the fetus.
D. If the external cephalic version works, we can attempt a trial of labor.
E. None of the above

Answer and topic summary

The answer is A. Since you have a previous classical cesarean incision, I recommend a repeat cesarean delivery

A “C-section” or cesarean delivery is defined as newborn delivery via an incision made surgically through the uterus. It is the safest method of delivery when fetal or maternal health is being compromised. There are many indications: refractory HELLP syndrome, placenta previa totalis, severe vaginal bleeding, uterine rupture, prolonged labor, abnormal fetal position, uterine structural abnormalities, pathologic CTG, fetal growth retardation with circulatory spring, certain fetal malformations, etc. There are 2 types of incisions: low-segment transverse incision (horizontal) and classical (vertical). Those who have had a classical incision are at risk for future uterine rupture and should have repeat cesarean births for future pregnancies.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Complicated Pregnancy ⇒ Cesarean delivery

Sign up for the ENTIRE Blueprint Daily Email Series (500 days and counting! 😀)

Sign Up
X