ACOG opinion paper on VBAC - American College of Obstetricians and Gynecologists Committee on Obstet

Author: Carrie Morantz, Brian Torrey
Date: Sept 15, 2002

The Committee on Obstetric Practice of the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion paper on induction of labor for vaginal birth after cesarean (VBAC) delivery. ACOG Committee Opinion No. 271 appears in the April 2002 issue of Obstetrics and Gynecology.

In an attempt to lower cesarean delivery rates in the United States, attention has been focused on increasing the percentage of VBACs. However, reports have suggested a significant risk of uterine rupture with poor outcomes for both the mother and infant attendant to VBAC attempts.

Although it is clear that the bulk of maternal and perinatal morbidity and mortality are caused by unsuccessful VBAC attempts, there are no reliable ways to predict whether a trial of labor will be successful in an individual patient. For these reasons, the safety of VBAC has been the subject of intense scrutiny.

The committee reviewed recent evidence and concluded that the risk of uterine rupture during VBAC attempts is substantially increased with the use of various prostaglandin cervical-ripening agents for the induction of labor, and their use is discouraged during VBAC attempts.

COPYRIGHT 2002 American Academy of Family PhysiciansCOPYRIGHT 2002 Gale Group

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