Authors:
Joshua D. Younger M.D., FACOG, Obstetric Anesthesia Attending, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI
Suzanne K.W. Mankowitz M.D., Obstetric Anesthesia Attending, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY
Kevin Spencer M.D., Senior Staff Anesthesia Attending, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI
Ami Attali D.O., Obstetric Anesthesia Attending, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI
This PBLD was peer-reviewed by a panel of experts from the Society of Obstetric Anesthesia and Perinatology (SOAP) and has been endorsed by the SOAP Education Committee.
Learners should identify a faculty mentor and walk through the case together, after perusing the pre-course work. Tweet your comments and questions using the buttons provided in each question, and experts will weigh in.
Required pre-work: Reading list
- Grobman W, et al. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010; 116(2 Pt 1):450-63.
- Apfelbaum JL, et al. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016; 124(2):270-300.
- Toppenberg KS, et al. Uterine rupture: what family physicians need to know. Am Fam Physician. 2002; 66(5):823-8.
Learning Objectives
Upon completion of this learning activity, participants should be able to
- Understand the various risks and benefits for a trial of labor after cesarean section (TOLAC)
- Gauge who is an appropriate candidate for a TOLAC
- Identify risk factors of uterine rupture in a TOLAC
- Identify early signs of uterine rupture in a TOLAC
Instructions for Faculty Mentor
Before proceeding with the case, perform an assessment of your fellow’s prior review of the teaching materials and current understanding of the topic. Review key points of learning, clarify any questions, and identify areas for further investigation by the fellow.
