DELIVERY AFTER PREVIOUS CAESAREAN SECTION

Trudnice sa prethodnim carskim rezom na kraju iduće trudnoće trebaju, u dogovoru s ginekologom odlučiti o njenom načinu dovršenja. Smjernice nalažu da takva trudnica u tijeku antenatalne skrbi treba biti dobro informirana i upućena u prednosti i rizike vaginalnog porođaja nakon prethodnog carskog reza, ali i ponovljenog carskog reza. Prilikom vaginalnog porođaja nakon prethodnog carskog reza važan je individualizirani pristup trudnici te dobro poznavanje rednosti i rizika takvog porođaja. Posebno se naglašava oprez u indukciji porođaja kao vodećem uzroku nastalih ruptura uterusa opčenito u porođaju, a posebice u pokušaju vaginalnog porođaja nakon carskog reza. U načelu, prethodni carski rez nije razlog za ponovljeni carski rez, ali spontani porođaj nakon prethodnog carskog reza može biti udružen sa većim rizikom, posebno kod postojanja dodatnih rizičnih čimbenika. Nakon procjene prednosti i nedostataka pojedinih metoda porođaja, u individualnom pristupu trudnici te uz pojačani oprez i nadzor treba se odlučiti za pristup koji je najpoštedniji s ciljem donošenja na svijet zrelog donošenog novorođenčeta sposobnog za samostalni postnatalni život i bez komplikacija za majku.Pregnant women with a previous caesarean section at the end of next pregnancy should decide on its way of completion. The guidelines require that such pregnant women during antenatal care should be well informed and acquainted with the benefits and risks of vaginal delivery after a previous cesarean section, but repeated cesarean section too. During vaginal delivery after a previous cesarean section, it is important to have an individualized approach to a pregnant woman and a good knowledge of the benefits and risks of such delivery. Caution in the induction of labor as the leading cause of uterine rupture is particularly emphasized especially in an attempt of vaginal birth after cesarean section. In principle, previous cesarean is not the reason for the repeated cesarean section but spontaneous labor after previous cesarean delivery may be associated with higher risk especially in the provision of additional risk factors. After assessing the strengths and weaknesses of the methods of childbirth, the decision is made individually for every pregnant woman with the aim of giving a birth of a mature fullterm newborn capable of independent postnatal life without complications for mother