A 29-year-old G3P2 at 38 weeks is in labor. She has a history of two previous cesarean sections. She is considering a vaginal birth after cesarean (VBAC). Which of the following is an absolute contraindication to a trial of labor after cesarean (TOLAC)?
- A Previous classical cesarean ✓
- B Unknown uterine scar type
- C Previous low transverse incision
- D Maternal request for VBAC
Correct answer: A. Previous classical cesarean
Explanation
C previous classical cesarean incision is an absolute contraindication to TOLAC due to the high risk of uterine rupture. C previous low transverse incision is the most favorable scar. An unknown uterine scar type is a relative contraindication. Maternal request for VBAC is not a contraindication if the patient is appropriately counseled.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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