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Delivery through the maternal bladder during trial of labor
1Colorado Permanente Medical Group, Saint Joseph Hospital, Denver.
Obstetrics and Gynecology
|September 1, 1992
Summary
Trial of labor after cesarean delivery is generally safe, with most women achieving vaginal birth. Rare complications, though serious, should not deter attempts at vaginal delivery after a prior cesarean.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Maternal-Fetal Medicine
Background:
- Numerous studies support the safety of trial of labor after cesarean (TOLAC).
- Vaginal birth after cesarean (VBAC) is achievable in approximately 75% of appropriately selected women.
- TOLAC offers a chance for vaginal delivery, avoiding risks associated with repeat cesarean surgery.
Observation:
- This report details two rare cases of infants delivered via the maternal bladder.
- One case involved uterine dehiscence during TOLAC.
- The second case involved vaginal rupture during TOLAC.
Findings:
- TOLAC can present with both standard and unique complications.
- Serious complications like bladder delivery are infrequent during TOLAC.
- Uterine dehiscence and vaginal rupture are rare but significant risks in TOLAC.
Implications:
- These infrequent complications should not discourage women from attempting vaginal birth after cesarean.
- Careful patient selection and monitoring remain crucial for successful TOLAC.
- Understanding rare complications enhances informed decision-making for TOLAC.