Deck 31: Birth Choices for Women With a Previous Cesarean Delivery

Question 1

Of the following indications for a previous cesarean which of these women will most likely have the greatest success for a vaginal birth if this is her second baby, she has a BMI and height in the normal range and has had an uncomplicated pregnancy.

A) Breech position
B) Failure to descend
C) Failure to progress
D) Fetal intolerance of labor

Answer 1

A

Question 2

Which of the following is not an element of shared decision making?

A) Assist with implementation
B) Evaluate options based on patient's goals/concerns
C) Provide information on benefits and risks
D) Recommend safest option

Answer 2

D

Question 3

Which of the following women is most likely to have success with a vaginal birth after a cesarean?

A) A26-year-old G2 P1 with a BMI of 32 and height of 63 inches with history of a cesarean for breech presenting for induction of labor at 41weeks
B) A 33-year-old G2 P1 with a BMI of 36 and height of 52 inches with history of a cesarean for failure to descend presenting in spontaneous labor at 39 weeks.
C) A 38-year-old G2 P1 with a BMI of 26 and height of 52 inches with history of a cesarean for fetal intolerance of labor presenting for induction of labor at 40 weeks.
D) A 40-year-old G2 P1 with a BMI of 24 and height of 65 inches with history of a cesarean for placenta previa presenting in spontaneous labor at 39 weeks.

Answer 3

D

Question 4

Which of the following women would not be a candidate for a trial of labor?

A) Previous emergency low transverse cesarean birth
B) Previous ovarian torsion following low transverse cesarean
C) Previous transfundal uterine surgery
D) Two previous low transverse cesarean births
E) Unknown uterine scar

Question 5

The overall success rate for vaginal birth after cesarean in the United States is closest to:

A) 50%
B) 60%
C) 75%
D) 82%

Question 6

Research shows that perceived provider preference significantly factors into a patient's decision to attempt a trial of labor after a previous cesarean.

Question 7

Uterine rupture during a trial of labor in the hospital setting is associated with maternal mortality.

Question 8

According to current evidence the risk of a uterine rupture for a woman in spontaneous labor choosing a trial of labor (TOL) after one previous cesarean and no previous vaginal births is closest to:

A) 0.47%
B) 0.55%
C) 0.67%
D) 0.88%
E) 1.0%

Question 9

Studies show that the neonatal mortality rate is higher for trial of labor compared to elective repeat cesarean.

Question 10

The risk of neonatal death following a uterine rupture in labor is closest to:

A) )5%
B) 1.6%
C) 6%
D) 15%
E) 20%

Question 11

Children born by cesarean have an increase risk of developing many health-related problems. Which of the following is not associated with cesarean birth?

A) Asthma
B) Attention-Deficit/Hyperactivity Disorder (ADHD)
C) Type 1 diabetes
D) Inflammatory bowel disease
E) Obesity

Question 12

M.S. is choosing to have an elective repeat cesarean birth. Her surgery should be scheduled for what gestational age:

A) 38 weeks
B) 39 weeks
C) 40 weeks
D) When labor begins

Question 13

Which of the following methods may be helpful in counseling a woman related to birth choices following a previous cesarean who has demonstrated low levels of health literacy and numeracy?

A) Evidence-based statistics
B) Icon arrays
C) Pictures of procedures
D) Written documents explaining risk