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在tolac這個產品中，有4篇Facebook貼文，粉絲數超過1,502的網紅康康醫師超音波共筆，也在其Facebook貼文中提到， 以前有一種說法，一朝剖腹產，終身剖腹產。 雖然這觀念已漸漸被推翻，有不少人開始嘗試剖腹產後的陰道生產，即VBAC (Vaginal birth after cesarean)或是TOLAC (Trial of Labor After Cesarean)。 但以前的人們到底在擔心甚麼呢? ...
　同時也有10000部Youtube影片，追蹤數超過2,910的網紅コバにゃんチャンネル，也在其Youtube影片中提到，...

tolac 在 康康醫師超音波共筆 Facebook 的最讚貼文

康康醫師超音波共筆 By 康康醫師超音波共筆

2020-11-15 22:05:00 有 97 人按讚
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<子宮傷口長好了沒? 超音波看得出來嗎?>

以前有一種說法，一朝剖腹產，終身剖腹產。

雖然這觀念已漸漸被推翻，有不少人開始嘗試剖腹產後的陰道生產，即VBAC (Vaginal birth after cesarean)或是TOLAC (Trial of Labor After Cesarean)。

但以前的人們到底在擔心甚麼呢?

😱😱😱主要就是怕子宮破裂😱😱😱

—-
不論是切除子宮肌瘤或是剖腹產，子宮都會有個傷口。之後因為疤痕組織的關係，彈性較差，在子宮收縮的時候比沒有傷口的子宮容易有破裂的風險。

既然如此，超音波能看得出來子宮的疤痕到底長好了沒???

很遺憾的😥，無法很好的判斷癒合程度。

—-

#子宮疤痕

開過剖腹產的人，在日後超音波追蹤下有時候可以看到子宮下段有明顯凹陷的疤痕。
但並不是看到疤痕，就表示傷口還沒癒合!

✏️通常子宮下段的延展性較佳，如果是傳統低位橫切的子宮傷口，破裂的機率相對較低。

#前胎子宮破裂

一位曾經接受過子宮肌瘤切除手術，上一胎經歷子宮破裂的人又懷孕了。
這一胎從很小週數就密集的幫她追蹤子宮壁的厚度，子宮壁在先前破裂處一直都看起來很薄(大約0.3公分)，只好硬著頭皮撐到過了34週，胎兒相對成熟的時間點，趕快排了時間幫她開刀生了一名健康的寶寶。

✏️根據文獻，前胎子宮破裂的孕婦，這胎適合剖腹產的時間大約為34週，最好不要超過36週。

#厚薄程度

✏️研究發現子宮越薄跟破裂的機率有相關。至於是多薄? 研究發現小於2~3.5mm都算薄，相對的風險也比較大。

但是是否小於這個厚度就一定沒辦法試自然產? 或是只要看到子宮肌肉層剩下這個厚度就要趕快開刀? 事實上也不然。

只是我們必須和醫師討論清楚有可能會遇到的狀況以及必須承擔的風險，再折衷討論出一個雙方都能接受且安全的決策!

—-
在此呼籲有接受過子宮手術的大家，生產與手術(或是兩次剖腹產)的時間不要間隔太近，相對來說也比較安全!

#子宮破裂
#前胎剖腹
#子宮疤痕懷孕
#早期植入性胎盤
#剖腹產適應症

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康康醫師超音波共筆

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鍾情超音波的婦產科醫師 建立這個衛教與傳承的小小園地 分享學習工作大小事
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tolac 在 陳鈺萍醫師 Facebook 的最佳貼文

陳鈺萍醫師 By 陳鈺萍醫師

2019-09-29 15:06:51 有 179 人按讚
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【#結構治療筆記】

懷孕36周嚴重子癲前症的孕婦Y，因為產檢醫生建議直接剖腹產而來門診找我，問我有沒有可能不開刀。「都到這個份上了，沒有辦法耶…」我無奈地回答。Y的眼淚馬上掉下來。

那是剛開始做溫柔生產的時候，很多孕婦因為諸多原因（價錢、是診所不是醫院的層級、要上助產師的產前教育…）初診後就跑掉了，常常到接近生產時因為產檢醫師的醫療建議跟他們的預期有出入，又跑回來問我第二意見。

37週那天Y在原產檢醫院剖腹產，產後一年血壓才恢復正常。第二胎一懷孕，就來我門診檢查，表明這胎想要嘗試剖腹產之後的陰道產（TOLAC）。通常第一胎有子癲前症，第二胎復發的比例非常高。那時，跟兩傳老師剛開始合作，討論結構治療在產科的運用，老師答應兩周的間隔調整有狀況的孕婦，看看會有什麼發現。Y很幸運地，排上讓老師親手調整的第四人。為了做為對照，調整前我請Y去做子癲前症的篩檢，果然還是高風險。我們討論後決定不吃阿斯匹靈，靠結構調整，看這次懷孕可否平安度過。產家也做了很多「非醫療方式」的努力，例如：用「鎂粉泡腳」。兩傳老師幫Y進行結構治療時，應證了我們對子癲前症的推論，而剖腹產的疤也是需要解開的。之後由潘醫師接手，我們就這麼一起照顧Y，到接近40週血壓都正常。但連續幾天入夜之後的規律宮縮，來產檢時血壓高起來了，隔天因有產兆入院，血壓在入院後節節高升…

潘醫師又跑了一趟「結構治療急診」。

潘醫師說，Y若需要剖腹，他會「捶心肝」，都調到這樣了。我說，Y的血壓若繼續高，我會先中風，要顧媽媽還是顧寶寶，有時無法兩全。潘醫師調整結構之前，血壓是179/107 mmHg，調整後為139/88mmHg，因宮縮而緊成一圈的下腹組織，也在調整加針灸之後鬆開來了，加上之前已經開始服用順產膏的作用，原本內診發現緊而扁的骨盆，開始變鬆而潤滑，形狀也開始改變，胎頭開始下降。我們很開心地各自回家，期待可以陰道產的好消息，沒想到半夜12點接到醫院的電話「陳醫師，血壓194/119 mmHg，產婦開始喊頭痛了。」「準備剖腹產！」再怎麼捶心肝也是得開了啊！

為何血壓又高起來？皮膚劃開後遇到的第一層筋膜很厚很硬，開進去各層肌肉筋膜之間很多地方要用刀多劃幾下才拉得開。若是第一次剖腹，我都盡量徒手撕不用刀，Y的疤痕組織又硬又緊撕不開。生產過程是動態的，結構調好之後是怎樣的機轉又拉回去？如兩傳老師說的要很多的「撕裂」嗎？包著子宮那層腹膜往左側黏，所以子宮拉歪一邊（伴隨扭轉），術中可以拉開去掉的沾黏盡量做。期待術後潘醫師再感覺看看，這次組織會不會長得不一樣。

Y的血壓術後馬上恢復正常，第一胎術後可是花了一年才恢復呀！雖然還是剖腹產了，但我們的努力並沒有白費。

========================================
節錄老師發表於《中華黃庭醫學會會刊》的〈溫柔生產〉

五，剖腹產後的陰道產
自然生產，對母親胎兒都比較好，有些媽媽第一胎剖腹產後，第二胎想要自然產，常常婦產科醫師是不贊同的，因為會面臨子宮破裂的危險，但是我想這是因為不知道如何評估風險而來。
跟上面的結構想法是一致，子宮會破裂，是因為子宮的上一次開刀傷口跟體壁黏連了，子宮的收縮的過程中，被體壁的疤痕扯住，才會造成破裂。如果把體壁跟子宮之間的疤痕黏連解開，第二胎要自然產是沒有什麼風險。
至於檢查的辦法，就是在體壁上搖動、拉扯疤痕組織，這個疤痕組織如果可以自在移動，沒有跟下方的結構黏在一起，那子宮收縮的時候就不會被體壁牽扯著了。

六，妊娠高血壓，糖尿病，蛋白尿，水腫
上面四種症狀，都是懷孕到一段時間後才會出現，然後生產完後慢慢就又消失掉。有的產婦不會有的會，應該也跟結構有關。
血壓會高，一定是身體某些地方缺血回饋造成的。子宮慢慢變大，佔據了整個筋膜原有系統的空間，使整個系統張力增加，而且脊椎的前後曲度也增加，因此主動脈搏出的動能就會受到某種程度的抑制，如果抑制的程度過大，會造成某些內臟或肢體末梢的缺血，這時血壓就會上升，以保證組織有足夠的供血量。
所以高血壓的孕婦，可以在坐著的時候，推動病人的背檢查脊椎的可動性，如果脊椎的可動性很不好，表示內在的筋膜張力也很大，就中醫的脈象來說，脈的底部會有搏動不起來的感覺。
如果是壓到內臟，引起內臟供血不足，則會出現相應的症狀。如果壓到胰臟，會出現消化不良脹氣的現象，而且可能還會伴隨著血糖過高。如果壓迫到腎臟，則會出現蛋白尿，及全身性的水腫。如果只是壓迫到鼠蹊兩側的股動脈，則只會有水腫而不會有蛋白尿的現象。
這些內臟的壓迫，可以從脈象上局部相應的變化得知，也可以做局部觸診，從整個筋膜系統的可動性檢查。

林兩傳2019.04.18桃園

+++++++++++++++++++++++++++++

全新出爐阿萍醫師講解順勢生產影片看這裡
https://youtu.be/MAVIBHof9mQ

影片 好孕動態開箱
攝影 黃約農 Dumas

#中西醫整合孕產照護
#蠢蛋天團無極限
#結構治療婦產分部
#獨步全球

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母親與孩子，從懷孕開始，透過胎盤血流，交織起一個新生命的醞釀過程，母親們開始想像自己與孩子的關係。身體一直在變化，隨時都有新發現。 懷孕的過程，造就了一位母親。許多孕婦在懷孕過程怕出錯，處在焦慮之中。她們遵循孕期營養守則，盡可能做每種檢查，上各種媽媽教室，在生產時只要醫護人員說什麼，都極力配合。這樣焦慮的懷孕過程，會不會讓媽媽們，離自然韻律遠了，用檢查報告堆砌了一座牆，把媽媽與寶寶越隔越遠呢？ 懷孕時，身體與荷爾蒙變化，不只保護了寶寶的生長與發育，也保護了媽媽。整個懷孕、生產至哺餵母乳的過程，媽媽的生理及情緒變化，都在為照顧寶寶醞釀。「所有的事在寶寶出生前就準備好了。」曾有學者這麼表示。阿萍醫師希望在此與大家分享，寶寶與媽媽身心一體的互動，從懷孕、生產、哺乳一直延續著。媽媽的身體在這段成長過程之中如何醞釀？ 每對母嬰都是獨特，阿萍醫師與你一起來探索。 好孕工作室 Moni's classroom monisclassroom.com 台北市大安區新生南路三段19巷3號 電話 02-23699362 陳鈺萍醫師門診時間請見官網 https://www.monisclassroom.com/moni/
懷孕、生產至哺餵母乳的過程，媽媽的生理及情緒變化，都在為照顧寶寶醞釀。寶寶與媽媽身心一體的互動，從懷孕、生產、哺乳一直延續著。 每對母嬰都是獨特，阿萍醫師與你一起來探索。
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tolac 在 楊于萱醫師（熙＆羽媽咪）的婦產科教室 Facebook 的最佳貼文

楊于萱醫師（熙＆羽媽咪）的婦產科教室 By 楊于萱醫師（熙＆羽媽咪）的婦產科教室

2017-11-05 22:57:03 有 46 人按讚
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產科醫鴻鳥 第一季-1 及
第二季-4 TOLAC(VBAC) 剖腹產後的自然生產

這次我想講的是產科醫師眼裡陪產老公絕對不能做的一些事（這兩集陪產老爸都做過很神奇的事件）

#如果你不想被唸一輩子千萬要記好

#1 寶寶出生不要急著衝去照相（會干擾新生兒處理），先好好安撫辛苦的老婆好嗎？

#2 如果爸爸真的很怕血，可以考慮好好扶住老婆（眼神不要亂飄）然後深呼吸，因為見血就暈的大隻佬我們真的沒空管。

#3 待產時如果無聊也不要公然無視老婆玩手機打遊戲或呼呼大睡，請真心參與過程。

第一季：明顯產程遲滯（胎兒過大還肩難產）的媽媽說想喝水，一邊話燒的老公聽到去也忙著去喝了幾口水（@@白眼）被護理師斥責

“給媽媽啦！！”

第二季：搞不清楚狀況的認真工作上班族老公在老婆說服下接受嘗試TOLAC，但陣痛開始後到院竟然問助產師小松

“請為大概何時生？能預測一下嗎？”
（因為跟朋友約好去坐船 @@大大白眼）

其實不管什麼方式，母子均安就好，就是因為我們無法預知可能會發生什麼事；如果私人保險能夠改變給付條件（不論生產方式一律給予定額補助），應該是最棒的。

#話雖如此生為一個前胎臀位第二胎做足準備想TOLAC卻怎麼也生不出來的人在家族中像是一個生產魯蛇(VBAC)，我已試過，我很努力了！

#產程無法預測一切只能聽從上帝安排

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楊于萱醫師（熙＆羽媽咪）的婦產科教室

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兩個公主的媽咪，也是提倡母奶,喜歡嘗試新事物（咖啡美食烹飪）的婦產科醫師
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コバにゃんチャンネル By コバにゃんチャンネル

2021-10-01 13:19:08 有 9 人看過 有 1 人喜歡
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コバにゃんチャンネル

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コバにゃん☆です?
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tolac 在 大象中醫 Youtube 的最讚貼文

大象中醫 By 大象中醫

2021-10-01 13:10:45 有 0 人看過 有 0 人喜歡
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大象中醫

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長照是一個劇變的旋轉舞台 百年難得一見 沒有準備的人 被旋轉舞台甩出去 不是坐下就是躺下 而大象中醫是太極的推手 推動著旋轉舞台 讓 所有爬不起來的人 背後有一股推手力量 支撐再站起來
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tolac 在 大象中醫 Youtube 的最佳貼文

大象中醫 By 大象中醫

2021-10-01 13:09:56 有 0 人看過 有 0 人喜歡
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大象中醫

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長照是一個劇變的旋轉舞台 百年難得一見 沒有準備的人 被旋轉舞台甩出去 不是坐下就是躺下 而大象中醫是太極的推手 推動著旋轉舞台 讓 所有爬不起來的人 背後有一股推手力量 支撐再站起來
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社群媒體上有些相關的討論：
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搜尋相關連結

#1. 剖宮產後陰道試產

剖宮產後陰道試產(Trial of Labour after Caesarean Section – TOLAC)：嘗試通過陰道進行分娩。大部分女. 性都可以順利進行剖宮產後陰道分娩（Vaginal Birth After ...

#2. TOLAC & VBAC - UChicago Medicine

Trial of labor after cesarean (TOLAC) is a planned or attempted vaginal birth after cesarean (VBAC). Sometimes, there is a need to change the plan, ...

#3. TOLAC - Wikipedia

Trial of labor after caesarean (TOLAC) is the term for an attempted birth in a patient who has had a previous caesarean section.

#4. VBAC and TOLAC in Pregnancy - Verywell Family

TOLAC (trial of labor after Cesarean) is the first step toward a vaginal delivery after Cesarean (VBAC). Learn about the benefits and risks ...

#5. TOLAC (Trial of Labor After Cesarean Delivery) - Health Library

You've had a cesarean section birth. Now you may wonder if you can try vaginal birth with your next baby. It's likely you can. The attempt to have a vaginal ...

#6. calculator-trial-of-labor-after-cesarean-tolac- - UpToDate

TOLAC · Choosing the route of delivery after cesarean birth · Calculator: Trial of labor after cesarean (TOLAC) for use at entry to prenatal care · Cervical ...

#7. VBAC and TOLAC - East Melbourne Obstetrics and ...

A trial of labor after caesarean (TOLAC) is a planned attempt to labor by a woman who has previously undergone a caesarean delivery and ...

#8. Trial of labor after cesarean delivery (TOLAC) in ... - PubMed

The TOLAC rate in Japan was considerably lower than that reported in other countries, despite comparable complication rates.

#9. TOLAC - Cancer Therapy Advisor

TOLAC (trial of labor after cesarean) refers to the decision to attempt a vaginal delivery after a cesarean section. VBAC refers to a vaginal delivery that ...

#10. Trial of Labor After Cesarean Section (TOLAC) - DynaMed

trial of labor after cesarean (TOLAC) - planned attempt to allow labor in women who had a previous cesarean birth, regardless of the outcome of ...

#11. Vaginal Birth After Cesarean Delivery | ACOG

ABSTRACT: Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to deliver vaginally by a woman who has had a previous cesarean ...

#12. Obstetricians' perspectives on trial of labor after cesarean ...

VBAC refers to a vaginal delivery following a successful trial of labor after CS (TOLAC), which is a trial of labor in women with a history of ...

#13. Acceptance of trial of labor after cesarean ... - Science Direct

This suggests that the TOLAC approach should be promoted because vaginal birth has more benefits to both mothers and babies; namely, it is associated with ...

#14. Vaginal Birth After Cesarean Delivery - Waterbury Hospital

Today, it is known that many women can undergo a trial of labor after a cesarean delivery (called TOLAC). After a successful TOLAC, many women will be able to ...

#15. VBAC: Know the pros and cons - Mayo Clinic

Many women are candidates for vaginal birth after cesarean (VBAC). In 2013, the success rate for women in the U.S. who attempted a trial of labor (TOLAC) after ...

#16. No. 382-Trial of Labour After Caesarean

TOLAC trial of labour after Caesarean. VBAC vaginal birth after Caesarean. SOGC CLINICAL PRACTICE GUIDELINE. 994 JULY JOGC JUILLET 2019 ...

#17. Effect of a Patient-Centered Decision App on TOLAC - Clinical ...

Number of participants who underwent a trial of labor after cesarean (TOLAC) delivery, as noted in the medical record. Secondary Outcome Measures : Number of ...

#18. Birth after caesarean | Better Safer Care

Successful trial of labour after caesarean (TOLAC) leading to vaginal birth after caesarean is associated with a lower risk of complications than elective ...

#19. Factors associated with the outcome of TOLAC after one ...

002) were the factors independently associated with failed TOLAC. Previous indication for a Caesarean Section and previous vaginal delivery were ...

#20. Trial of Labor after Cesarean (TOLAC) - Pearls of Exxcellence

Options following a cesarean delivery include elective repeat cesarean delivery and trial of labor after cesarean (TOLAC).

#21. TOLAC Counseling (Trial Of Labor After C-section)

contraindications to TOLAC. Prior classical, T or high transverse incision. Prior uterine rupture. Extensive transfundal uterine surgery. Placenta Previa.

#22. TOLAC Archives - The ObG Project

While trial of labor after cesarean delivery (TOLAC) may be considered after previous cesarean delivery, it is critical that a thorough review of risks and ...

#23. Factors Associated with Successful Trial of Labor after ...

Of the women that participated in TOLAC, 355 (60%) had successful TOLAC or vaginal birth after cesarean section (VBAC), while 237 (40%) had ...

#24. Trial of Labor After Cesarean Section (TOLAC) - Medscape ...

AAFP Guidelines for TOLAC · Recommendation 1. All women with 1 previous cesarean delivery with a low transverse incision are candidates for and should be offered ...

#25. Acceptance Of Trial Of Labor After Cesarean (Tolac) Among ...

PDF | Background Babies to women eligible for trial of labor after a cesarean (TOLAC) are sometimes delivered by cesarean section (CS).

#26. TOLAC (trial of labor after cesarean) - OBGYN CARE

TOLAC is a term that replaced VBAC (vaginal birth after cesarean) in medical use, acknowledging that not every attempt to deliver vaginally after cesarean ...

#27. 626: Trial of labour after cesarean (TOLAC) - American ...

TOLAC exclusions were: preterm, multi-fetal, non-cephalic presentation, or delivered by prelabor CD. TOLAC intrapartum CDs were included if there was evidence ...

#28. ACOG Updates Recommendations on Vaginal Birth After ...

Because most maternal morbidity during TOLAC occurs when repeat cesarean delivery becomes necessary, VBAC is associated with fewer complications ...

#29. Trial of Labor After Cesarean (TOLAC) Checklist (05/01/17)

Labor After Cesarean (TOLAC). If there are any "Does Not Meet" responses. Do Not Proceed with a Trial of Labor. Patient Selection Criteria (may be initiated ...

#30. SOGC Statement on Trial of Labour after Cesarean (TOLAC ...

SOGC Statement on Trial of Labour after Cesarean (TOLAC) Birth during the COVID-19 Pandemic.

#31. Vaginal Birth After Cesarean (VBAC) | Michigan Medicine

What are the benefits of a TOLAC? · Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. · Less pain after delivery.

#32. TOLAC: Can I Have a Trial of Labor After Cesarean? | Parents

TOLAC vs VBAC: What's the Difference? TOLAC (trial of labor after cesarean) happens when a woman attempts to give birth vaginally after C- ...

#33. PBLD5: Trial of Labor after Cesarean Delivery (TOLAC)

PBLD5: Trial of Labor after Cesarean Delivery (TOLAC). Tweet to @SOAPhq. Case Description. A 39-year-old G9P4044 at 42 weeks gestation presents for a ...

#34. ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean...

Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to deliver vaginally by a.

#35. Trial of Labor after Cesarean (TOLAC) for Vaginal Birth after ...

This increase in TOLAC also revealed an increase in TOLAC related complications, such as uterine rupture-related maternal and fetal morbidity. “ ...

#36. TOLAC — Weekly Notes - CREOGS Over Coffee

With ever increasing volumes of cesarean delivery, TOLAC has become a popular option for patients desiring vaginal delivery.

#37. (VBAC) calculator - MFMU Network

An updated version of the Vaginal Birth After Cesarean (VBAC) calculator can be found here.

#38. INFORMATION AND CONSENT FOR WOMEN WITH A PRIOR ...

Not all women will be able to have a successful vaginal birth after cesarean. About 60-80% of women attempting TOLAC will end up with a vaginal delivery. If I ...

#39. Vaginal Birth After Cesarean Delivery - Medscape Reference

Although attempts at a trial of labor after a cesarean birth (TOLAC) have become accepted practice, the rate of successful vaginal birth after ...

#40. Vaginal Birth After Caesarean (VBAC) | AOM - Ontario Midwives

Choosing to VBAC/TOLAC at home is a client decision that is difficult for many care providers, and midwives are in a position of having unique ...

#41. Vaginal Birth after Cesarean (VBAC) Guideline - MaineHealth

success2, and alternatives of a trial of labor after cesarean delivery (TOLAC). Contraindications to TOLAC: • More than two previous low-transverse cesarean ...

#42. ObGyn Professor Co-Author of New SOGC TOLAC Guideline

Each year in Canada, over 30,000 pregnant women who have had a previous Caesarean section (CS) must decide between TOLAC and elective repeat ...

#43. Epidural analgesia at trial of labor after cesarean (TOLAC)

We evaluated the association between exposure to epidural during TOLAC and mode of delivery and maternal-neonatal outcomes. Materials and ...

#44. Vaginal Birth After Cesarean: Is Having A VBAC The Right ...

If you choose to deliver vaginally after previously having a C-section, this labor process is known as a trial of labor after cesarean (TOLAC).

#45. Factors Contributing to Trial of Labor after Caesarean (TOLAC ...

(1) Successful TOLACs have reduced perinatal complications including bleeding, thrombosis, and infection. (2) TOLAC has a minimal risk of ...

#46. Trial of labor after cesarean guidelines - Alaska Native ...

Most women with one or two prior cesarean delivery(s) with low transverse uterine incision are candidates for TOLAC and should be counseled about the risks, ...

#47. a cross-sectional study,BMC Pregnancy and Childbirth - X-MOL

Promoting trial of labor after CS (TOLAC) can reduce the CS rate without compromising delivery outcomes. This study aimed to investigate Ch.

#48. Want a VBAC? Read On! A TOLAC (Trial of Labor after ...

However, neither repeat Cesarean delivery nor TOLAC is without risk. Vaginal Birth after Cesarean is associated with fewer complications, but a ...

#49. Patient and Family Preferences Strongly Influence Decisions ...

In women eligible for a trial of labor after cesarean delivery (TOLAC), predictors of undergoing TOLAC were strength of preference for ...

#50. Effect of a Patient-Centered Decision App on TOLAC - Global ...

Our study also will generate evidence on the effectiveness of this app in increasing TOLAC rates and improving decision quality.

#51. The 5-minute Obstetrics and Gynecology Consult

Oxytocin use is considered reasonable in TOLAC induction and augmentation . • Epidural is not contraindicated in TOLAC . SURGERY Cesarean delivery ( See ...

#52. TOLAC COUNSELING - Obstetrics & Gynecology

TOLAC COUNSELING. Week 23. Prepared by Holli Jakalow, MD. Reading Assignment: ACOG Practice Bulletin #205. Vaginal Birth after Cesarean Delivery ...

#53. Should lower uterine segment thickness measurement be ...

Furthermore, only 28% of women attempt a TOLAC, with a successful vaginal birth after cesarean (VBAC) rate of approximately 57%. 1. The reason for the low TOLAC ...

#54. IOL TOLAC Poster_SMFM2018v6 - Medical College of ...

Safety and Efficacy of the Foley Balloon for Cervical Ripening. During Induction of Labor in Women with Prior Cesarean. Jessika Ralph, MD1, Heidi Leftwich, ...

#55. 9th ECOWAS Traditional Wrestling Tournament (TOLAC) in ...

9th ECOWAS Traditional Wrestling Tournament (TOLAC) in Dakar: Referees and wrestlers ready for the commencement of the tournament.

#56. Birth After Previous Caesarean Birth - RCOG

The search was restricted to articles published between 2003 and February 2015. Search words included 'VBAC', 'TOLAC', 'vaginal birth after caesarean', ' ...

#57. Trial of Labor after Cesarean (TOLAC) - Bedford Commons ...

Trial of Labor after Cesarean (TOLAC). July 8, 2020 | Dr. Kristen Bannister. So you had a cesarean for your first delivery and now you are pregnant again.

#58. TOLAC and VBAC and Rupture! Oh My! - AWHONN ...

There are many indications where a cesarean delivery is absolutely necessary. In the case of an elective repeat section or a TOLAC, it is ...

#59. TOLAC/VBAC Info & Consent - Community Midwives of Halton

IMPORTANT: Due to COVID-19 partners and children will NOT be allowed in the clinic. TOLAC/VBAC Info & Consent.

#60. information and consent for women - PatientPop

attempting TOLAC will end up with a vaginal delivery. If I choose a TOLAC and end ... Elective repeat cesarean (the choice other than TOLAC) also has risks.

#61. VBAC and TOLAC: Making Sense of Obstetric Choices

VBAC and TOLAC: Making Sense of Obstetric Choices. Doctor checking the patient. Creating a birth plan can be a nerve-wracking process, ...

#62. Epidural analgesia at trial of labor after cesarean (TOLAC)

Epidural analgesia has been considered a risk factor for labor dystocia at trial of labor after cesarean (TOLAC) and uterine rupture.

#63. vbac (tolac) - Nye Partners In Women's Health

VBAC (Vaginal Birth After Cesarean Section) is also called TOLAC (Trial of Labor After Cesarean Section). For some mothers who have had a cesarean delivery.

#64. Vaginal-Birth-After-Cesarean-Delivery.pdf - Kessler Women's ...

What are the risks of a TOLAC? With TOLAC, the risk of most concern is the possible rupture of the cesarean scar on the uterus or the uterus itself. Although a ...

#65. Managing the Risk of Uterine Rupture During a Trial of Labor ...

Most women with one prior cesarean section with a low-transverse incision are candidates for TOLAC/VBAC. • Epidural analgesia may be used during TOLAC. Comment: ...

#66. Counseling Women on Modes of Birth After Cesarean Accepted

used was TOLAC - Trial of Labor after Cesarean). Elective Repeat Cesarean Birth (ERCB): Extraction of the fetus(es) through an abdominal.

#67. Vaginal Birth After Caesarean (VBAC)

What are the benefits of a TOLAC and VBAC? · Avoiding another scar on your uterus. · Less pain after delivery. · Fewer days in the hospital and a shorter recovery ...

#68. Trial of labor after cesarean delivery ... - Springer Medizin

We collected data on delivery method, particularly with regard to the involvement of TOLAC or elective repeated cesarean deliveries (ERCD).

#69. Trial of Labor After Cesarean Section 16th Edition(pub Sep-6 ...

Candidates for planned TOLAC are those women in whom the balance of risks and chances of success are acceptable to the woman and the healthcare ...

#70. What is TOLAC? Understanding Birth Terms – The VBAC Link

The TOLAC medical abbreviation stands for Trial Of Labor After Cesarean. If a pregnant woman has only had vaginal birth before, or is pregnant ...

#71. ruptur uteri sebagai komplikasi tolac pada pasien dengan ...

Pasien menolak untuk terminasi kehamilan melalui tindakan seksio sesaria dan diputuskan untuk menjalani TOLAC dengan skor VBAC (Vaginal birth after cesarean ...

#72. Responsible Department - UNM Hospitals

TOLAC offers women with a previous cesarean section the opportunity for a vagina, birth after cesarean (VBAC) instead of an elective repeat cesarean.

#73. Obstetric Evidence-Based Guidelines, Second Edition

Hysterectomy The risk of hysterectomy is about 1 to 2/1000 TOLAC (6–8,12,60,66), and similar to PRCD (7). Transfusion The risk of transfusion is very low, ...

#74. Trial of labor after cesarean section in risk pregnancies

TOLAC failure was defined as an acute or unspecified CS in a TOLAC delivery. A similar approach was validated in a separate study, and found to ...

#75. Vaginal Birth Often Possible Despite Previous C-Sections

Will a TOLAC succeed? Roughly 1 in 3 women in the United States deliver their baby by cesarean section. In the past, it was recommended that women with a ...

#76. Poród drogą pochwową po cięciu cesarskim - Via Medica ...

... próby porodu drogami natury u pacjentek, które rodziły już przez cięcie cesarskie (TOLAC, trial of labour after cesarean section).

#77. 剖宫产后阴道试产中子宫破裂的早期识别

研究期间TOLAC孕产妇共221例，其中子宫破裂8例（完全子宫破裂4例，不全子宫破裂4例），TOLAC中完全子宫破裂率1.8%；发现于第一产程7例，第三产程1例； ...

#78. Effect of a patient-centered decision app on TOLAC: An RCT

A primary driver of the decreased frequency of VBAC is the decline in frequency with which eligible women elect a trial of labor after cesarean (TOLAC).

#79. Birth after previous caesarean section - RANZCOG

after Caesarean (TOLAC) or Next Birth after Caesarean (NBAC). ▫ ERCS: Elective repeat Caesarean section. Planned Caesarean section in a woman who has had ...

#80. Outcome with trial of labor after cesarean (TOLAC) or elective ...

Outcome with trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery on maternal request (ERCD-MR): a comparative study ...

#81. VBAC/TOLAC - choice or coercion - Dr Sean Holland

One area of controversy relates to the topic of vaginal birth after caesarean section (VBAC or TOLAC - trial of labour after caesarean).

#82. Maternal and obstetrical factors associated with a successful ...

An unsuccessful TOLAC is defined as fail- ure to achieve a vaginal birth after cesarean section in women undergoing a TOLAC and the delivery ...

#83. Hospitals differ widely in providing safe vaginal delivery after ...

So appropriate use of TOLAC plays an important role for improving long-term reproductive health of American women.” Examining data from the ...

#84. Obstetrics: Normal and Problem Pregnancies E-Book

In 1999, ACOG issued a practice bulletin5 acknowledging that while the risks of TOLAC were apparently small in magnitude, clinically significant risks of ...

#85. Predicting the success of vaginal birth after caesarean delivery

Results Of the women who planned for TOLAC, 84.0% (1686/2006) had VBAC. Gestational age, history of vaginal delivery, estimated birth weight, ...

#86. Informed Consent Form: Trial Of Labor After Cesarean (TOLAC)

Trial Of Labor After Cesarean (TOLAC). The purpose of this document is to provide you with the required information on the.

#87. Study of TOLAC (trial of labour after caesarean) at a tertiary ...

Trial of labor after cesarean delivery (TOLAC) refers to a planned attempt to ... Key Words: Post Caesarean Pregnancy, TOLAC, VBAC, Maternal Outcome, ...

#88. Obstetrics: Normal and Problem Pregnancies E-Book

The panel at that conference concluded that TOLAC is a reasonable birth option for many women with a previous cesarean delivery. The panel also found that ...

#89. Obstetrics: Normal and Problem Pregnancies

It was also recognized that such adverse events during a TOLAC may lead to malpractice suits.51 ACOG thus recommended that TOLAC be conducted in settings in ...

#90. A study of the determinants of success of trial of labour after ...

A study of the determinants of success of trial of labour after cesarean (TOLAC) in a tertiary centre of Haryana - IJOGR- Print ISSN No: - 2394-2746 Online ...

#91. Vaginal Birth after Cesarean and Trial of Labor after Cesarean

When the physician and patient are considering TOLAC, several factors should be considered: risk of uterine rupture, contraindications, ...

#92. Trial of Labor After Cesarean: A Powerful Clinical Option

Successful TOLAC with an uncomplicated vaginal birth is safer than RCD due to lower risks for maternal hemorrhage, wound infection, and death; ...

#93. Recommendations for intrapartum management of TOLAC

TOLAC may be desirable for certain patients, as repeat Cesarean deliveries can increase risk for abnormal placentation and pelvic adhesions.

#94. Trial of Labour After Ceasarean Section (TOLAC) - YouTube

#95. Trial of labor after previous cesarean delivery (TOLAC) and ...

Trial of labor after previous cesarean delivery (TOLAC) and association of BMI and previous vaginal delivery with frequency of VBAC ...

#96. TOLAC Specialist - Seasons Of Life OBGYN

A TOLAC is an attempt to give birth vaginally when your last birth was a C-section. If your TOLAC is successful, it's called a vaginal birth ...

#97. Morbidly obese gravidas: Labor or not? - Contemporary OB/GYN

Since then, TOLAC has been advocated as a reasonable alternative for women with a previous cesarean delivery via a low transverse uterine ...