Geburtshilfe Frauenheilkd 2016; 76(12): 1279-1286
DOI: 10.1055/s-0042-118335
Consensus Recommendation
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Labour and Childbirth After Previous Caesarean Section

Recommendations of the Austrian Society of Obstetrics and Gynaecology (OEGGG)Geburt nach vorausgegangenem KaiserschnittEmpfehlung der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG)
P. Reif
1   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
,
C. Brezinka
2   Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Austria
,
T. Fischer
3   Universitätsklinik für Frauenheilkunde und Geburtshilfe der Paracelsus Universität Salzburg, Salzburg, Austria
,
P. Husslein
4   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Wien, Vienna, Austria
,
U. Lang
1   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
,
A. Ramoni
5   Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck, Austria
,
H. Zeisler
4   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Wien, Vienna, Austria
,
P. Klaritsch
1   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2016 (online)

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Abstract

The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patientʼs wishes into account. In view of good success rates (60–85 %) for vaginal birth after caesarean section (VBAC) the consideration of predictive factors during antenatal birth planning has become increasingly important. This publication provides a compact management recommendation for the majority of standard clinical situations. However it cannot and does not claim to cover all possible scenarios. The consideration of all relevant factors in each individual case, and thus the ultimate decision on mode of delivery, remains the discretion and responsibility of the treating obstetrician.

Zusammenfassung

Die neue Expertenempfehlung der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG) stellt eine Zusammenfassung und Interpretation der Guidelines der weltweit führenden Fachgesellschaften und Organisationen (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate) dar. In ihrer Kernaussage zeigt die Empfehlung Alternativen zum direkten Weg zur geplanten Re-Sectio auf. Sie folgt damit dem internationalen Trend, der stattdessen ein differenziertes, individualisiertes klinisches Management unter Abwägen mütterlicher und kindlicher Vorteile und Risiken sowie eine detaillierte Aufklärung und Miteinbeziehung der Wünsche der Schwangeren empfiehlt. Angesichts guter Erfolgsraten für eine vaginale Geburt nach Kaiserschnitt von 60–85 % gewinnt das Einbeziehen von prädiktiven Faktoren in die antenatale Geburtsplanung zunehmend an Wichtigkeit. Die Empfehlung versteht sich als kompakte Handlungsempfehlung für die meisten klinischen Standardsituationen, kann jedoch niemals alle potenziellen Einzelsituationen abdecken. Das individuelle Bewerten aller Faktoren und damit die Entscheidung über den tatsächlichen Entbindungsmodus bleibt letztendlich im Ermessen des behandelnden Facharzts/der behandelnden Fachärztin.

Key words

caesarean section - status after caesarean section - vaginal delivery - management - recommendation - assessment

Schlüsselwörter

Kaiserschnitt - Zustand nach Kaiserschnitt - vaginale Geburt - Management - Empfehlung - Bewertung

Supporting Information

 

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