A 26-year-old woman at 37 weeks with one previous lower segment cesarean section presents in early labour requesting a trial of labour after cesarean (TOLAC). Which of the following is a contraindication to TOLAC?
- A Previous cesarean for breech presentation
- B Unknown uterine scar type ✓
- C Gestational diabetes on insulin
- D Previous vaginal delivery after cesarean
Correct answer: B. Unknown uterine scar type
Explanation
An unknown uterine scar type is a contraindication to TOLAC because a classical (vertical) uterine incision carries a significantly higher risk of uterine rupture (4 to 9 percent) compared to a low transverse scar (0.5 to 1 percent). The type of previous uterine incision must be confirmed before offering TOLAC.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.