TOLAC Defined - James Summers, DO Obstetrics Gynecology скачать в хорошем качестве

TOLAC Defined - James Summers, DO Obstetrics Gynecology

What is TOLAC or trial of labor after cesarean section as defined by James Summers, DO Obstetrics Gynecology? The use of cesarean section to deliver newborns has ballooned to over 30 percent nationwide in the recent 40+ years. Not every patient who has a had a cesarean section will need another with a subsequent pregnancy, however. The practice of TOLAC has grown in hospitals where pregnant women are cared for. This practice has some specific criteria that need to be met 1. Paramount to the safe practice of TOLAC is the presence of both anesthesia and a surgical Obstetrical provider who are immediately available for the patient who wants to have a vaginal birth after cesarean. 2. Patient selection is important as well given the nature of her previous timing and reason for cesarean section. This must be assessed before the patient presents to the labor unit where she will undergo her trail of labor. 3. A vigorous informed consent process needs to be in place, ideally before the patient presents for her trial of labor. What is the process and timing of a TOLAC or trial of labor after cesarean section? At Banner, we start this communication/process early in prenatal care – We start by 28 weeks. This discussion is usually ongoing as documentation of previous delivery scar and timing needs to be reviewed. We review, discuss and sign a detailed informed consent while we are discussing in clinic as well as when the patient presents to labor and delivery at Banner North Colorado Medical Center. With the advent of our inpatient Obstetrical program at NCMC, the presence of a board-certified Obstetrician is guaranteed for these patients. Throughout the patient’s labor, there is continuous/constant evaluation of labor progress ensuring safety for the mother and baby. Interventions on behalf of the mother and/or baby happen in real time. Throughout the process, we recognize the mother’s choice to either continue with her trial of labor (within safety standards) versus a decision to proceed with C-section based on maternal request as needed. Additionally, we have a level three nursery on site with neonatal nurse practitioners and board-certified neonatologist in case there is any need for immediate intensive assessment of the newborn. A final thought: The best way to manage a trial of labor after cesarean, is to avoid cesarean section in the first place. At NCMC we have driven our primary cesarean section rate down to 20 percent. We continue work to safely decrease our cesarean delivery rate through safe processes, education, collaboration with our nursing and resident staff, and developing/following best practices for the safe delivery of babies in northern Colorado. Speaker: James Summers, DO Obstetrics Gynecology – Medical Director of Women’s Services in northern Colorado Board Certifications: OB/GYN American Board of Obstetrics and Gynecology, 2005 Banner Health is committed to follow up with you after each appointment to keep you informed of the care plan. Banner Health: https://www.bannerhealth.com Schedule Appointment: https://doctors.bannerhealth.com/prov... BMG Specialty Referral for Evaluation in Northern Colorado Email: [email protected] Phone: 970-820-6702 or 970-820-6704 Fax: 970-237-3790 #BannerHealth #gynecologist #TOLAC