Previous Caesarean Section X1: DOB: ______/______/______One Previous Caesarean Section Suitable For
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Addressograph Name:____________________________ Address:__________________________ _________________________________ Previous Caesarean Section x1: DOB: _________/_________/_________ One previous caesarean section suitable for NHS No.__________________________ vaginal birth - see exclusion criteria for VBAC clinic on VBAC referral form GESTATION PURPOSE OF VISIT Booking history Complete VTE Risk Assessment refer to MOP if score ≥3 6-10 Assess suitability for VBAC from Medway previous delivery comments and complete Community VBAC Clinic referral form, if not suitable or unsure state on booking referral requires High Midwife Risk Appointment (CMW) Consider referral to Birth Choices Clinic if requires debrief from last labour/birth Give information leaflet MCHFT Birth After a Previous Caesarean Section 11-13 Low Risk Dating scan and NT with consent Maternity Outpatients Review previous maternity notes (MOP) 16-18 Antenatal Assessment CMW 18-20 Low Risk Anomaly Scan including placental site MOP Anterior placenta praevia or covers os – arrange USS rescan 32 weeks Sonographer Posterior placenta in the lower segment – arrange USS 36 weeks VBAC Clinic Discuss Plans for Birth Midwife Complete VBAC risk assessment and proforma or Discuss plan for birth e.g. preterm, post dates Consultant If wishes caesarean section book date in 39th weeks of pregnancy and complete consent. Clinic If undecided book appointment for 36 weeks. 28 Antenatal assessment CMW 31 Antenatal Assessment CMW 32 USS only for anterior placenta at 20 week scan and review by MOP midwife MOP If placenta remains anterior or covers the os refer to Fetal Medicine Clinic within 2 weeks to exclude adherent placenta 34 Antenatal Assessment CMW 36 USS only if placenta was posterior and in lower segment at 20 weeks and review by MOP MOP midwife If placenta still low ,review by Obstetrician Antenatal Assessment 36 Women who are undecided re; mode of delivery to have further discussion re plans for CMW birth and make appointment for obstetric review if wishes EL LSCS MRSA screening if booked for EL LSCS Plot SFH on GROW chart Antenatal Assessment 38 Make appointment for obstetric review to discuss post dates management CMW Offer membrane sweep if aiming for VBAC FBC if booked for EL LSCS Antenatal Assessment 40 Offer membrane sweep MOP Book IOL or repeat Caesarean depending on plan 41 Antenatal Assessment CMW Offer membrane sweep THIS PATHWAY MAY BE ADAPTED TO THE NEEDS OF THE MOTHER AND HER BABY AS PREGNANCY PROGRESSES. THIS MAY INCLUDE EXTRA APPOINTMENTS AS NECESSARY. V1.1 January 2021 Page 1 of 1 .