6 Questions
What are the two main options for patients who have undergone a previous cesarean birth in a subsequent pregnancy?
Trial of labor after cesarean (TOLAC) birth and planned repeat cesarean birth (PRCB)
What does TOLAC stand for?
Trial of labor after cesarean
What should decision-making regarding mode of birth take into consideration?
Patient's personal preferences, obstetric history, risks and benefits of TOLAC versus PRCB, and availability of TOLAC
What may planned TOLAC result in?
Labor with vaginal birth (VBAC) or unplanned intrapartum cesarean birth
When was the literature review current through?
Feb 2023
Maternal Floor Infarction. This extreme variant of perivillous fibrin deposition is a dense fibrinoid layer within the placental basal plate and is erroneously termed an infarction. Maternal floor infarction has a thick, yellow or white, firm corrugated surface that impedes normal maternal blood flow into the intervillous space. In specific cases that extend up and beyond the basal plate to entrap villi and obliterate the intervillous space, the term massive perivillous fibrin deposition is used. The etiopathogenesis is unclear, but maternal auto- or alloimmunity appears contributory (FayePeterson, 2018; Romero, 2013). Antiphospholipid antibody syndrome and angiogenic factors involved with preeclampsia also have been implicated (Sebire, 2002; Whitten, 2013)
Study Notes
Previous Cesarean Birth
- Two main options for patients who have undergone a previous cesarean birth in a subsequent pregnancy:
- TOLAC stands for Trial of Labor After Cesarean
- Decision-making regarding mode of birth should take into consideration individual circumstances and risks
Maternal Floor Infarction
- Maternal floor infarction is a dense fibrinoid layer within the placental basal plate
- It impedes normal maternal blood flow into the intervillous space
- Characterized by a thick, yellow or white, firm corrugated surface
- In severe cases, it can extend up and beyond the basal plate, entrapping villi and obliterating the intervillous space, and is termed massive perivillous fibrin deposition
- Etiopathogenesis is unclear, but maternal auto- or alloimmunity appears contributory
- Antiphospholipid antibody syndrome and angiogenic factors involved with preeclampsia have been implicated in the development of maternal floor infarction
Explore the optimal delivery route after cesarean birth with this quiz. Test your knowledge on the latest evidence and guidelines for choosing delivery methods, authored and reviewed by medical experts.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
