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master's thesis
Vaginalni porođaj nakon prethodnog carskog reza
Zagreb: University of Zagreb, School of Medicine, 2019. urn:nbn:hr:105:954696
Trkulja, Marin
University of Zagreb
School of Medicine
Department of Gynecology and Obstetrics

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Trkulja, M. (2019). Vaginalni porođaj nakon prethodnog carskog reza (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:954696

Trkulja, Marin. "Vaginalni porođaj nakon prethodnog carskog reza." Master's thesis, University of Zagreb, School of Medicine, 2019. https://urn.nsk.hr/urn:nbn:hr:105:954696

Trkulja, Marin. "Vaginalni porođaj nakon prethodnog carskog reza." Master's thesis, University of Zagreb, School of Medicine, 2019. https://urn.nsk.hr/urn:nbn:hr:105:954696

Trkulja, M. (2019). 'Vaginalni porođaj nakon prethodnog carskog reza', Master's thesis, University of Zagreb, School of Medicine, accessed 30 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:954696

Trkulja M. Vaginalni porođaj nakon prethodnog carskog reza [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2019 [cited 2024 April 30] Available at: https://urn.nsk.hr/urn:nbn:hr:105:954696

M. Trkulja, "Vaginalni porođaj nakon prethodnog carskog reza", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2019. Available at: https://urn.nsk.hr/urn:nbn:hr:105:954696

Metadata
TitleVaginalni porođaj nakon prethodnog carskog reza
Title (english)Vaginal birth after cesarean delivery
AuthorMarin Trkulja
MentorGordan Zlopaša (mentor)
Committee memberVesna Elveđi Gašparović (predsjednik povjerenstva)
Committee memberDinka Pavičić Baldani (član povjerenstva)
Committee memberGordan Zlopaša (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Gynecology and Obstetrics)
Zagreb
Defense date and country2019-07-12, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Gynecology and Obstetrics
Abstract
Žene s prethodnim carskim rezom u anamnezi trudnoću mogu dovršiti ponovnim planiranim carskim rezom (PRCD) ili vaginalnim porođajem nakon prethodnog carskog reza (TOLAC/VBAC). Globalni porast incidencije carskog reza kao metode dovršenja trudnoće odnosi se djelomice i na češće izvođenje PRCD-a nego li je to objektivno potrebno. Iako je u proteklih desetak godina konstruirano više kliničkih sustava za procjenu vjerojatnosti uspješnog vaginalnog porođaja (VBAC kalkulator, MFMU Network kalkulator, modeli predviđanja), niti jedan od njih nije potvrđen (eksterno validiran) u prospektivnom kohortnom istraživanju. Potencijalni razlog zaziranja porodničara od TOLAC protokola mogao bi biti povećan rizik rupture maternice, međutim, na umu treba imati onaj postotak trudnice koje su mogle trudnoću dovršiti VBAC-om, ali to nisu učinile, što je najčešće posljedica propusta liječnika u antenatalnom savjetovanju i informiranju trudnice o njezinim izgledima za VBAC. Ruptura maternice potencijalno je fatalna komplikacija vaginalnog porođaja koja je češća u kontekstu TOLAC-a, a rizik raste korištenjem prostaglandina u indukciji porođaja. Iako je carski rez povezan sa značajno većim maternalnim negoli fetalnim morbiditetom i mortalitetom, mnoge će trudnice zanemariti svoje rizike, ako carski rez u konkretnom slučaju povećava šanse za preživljenje djeteta i bolji neonatalni status.
Abstract (english)
Women with a previous cesarean section can choose either planned repeated cesarean delivery (PRCD) or vaginal birth after cesarean (VBAC) as a way to end their current preganancy. More frequent PRCDs, although not always with a reasonable indication, are partially accountable for a global raise of incidence of cesarean section. Although some prediction models of successful VBAC have been developed in the past decade (VBAC calculator, MFMU Network calculator, prediction models), none of them have been externally validated in a prospective cohort study. An increased risk of uterine rupture associated with TOLAC /VBAC arises as a possible reason for some clinicians to avoid TOLAC. One has to bear in mind the percentage of women who could have successfully completed VBAC, but haven't done so, mostly due to antenatal counsseling malpractice and not knowing their own chance of success. Uterine rupture is a potentially fatal complication of vaginal birth, which happens to be more common in the setting of TOLAC, and if prostaglandines are used for labor induction the risk becomes even higher. Although cesarean section bears more morbidity and moratality risks for the mother than for the child, many women will undergo cesarean section if they are told it would improve the survival rate and neonatal status of the newborn.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:954696
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2019-11-27 14:41:19