Page 17 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

• Bed rest

• Hospitalization

• Delivery
30

For postpartum stroke, the period of highest risk normally

occurs during the first 10 days after hospital discharge. It is
31
crucial to closely monitor patients with hypertensive disorders
for the first 72 hours postpartum, reevaluating them within

7 to 10 days postpartum as recommended by ACOG. The
32
coordination of early postpartum care with blood pressure
assessment along with patient education, the assurance of
patient access to prescribed medication(s), and appropriate

long-term care is encouraged.
33 34

VBAC/TOLAC

Vaginal birth after cesarean section (VBAC) or Trial of Labor
After Cesarean (TOLAC) is a high-risk delivery, given the

possibility of uterine rupture and because of the severity of
potential malpractice claims. Risks associated with VBAC

delivery should be taken into consideration before a VBAC
is determined to be a birth plan, and a “game plan” must

be developed and implemented in order to minimize risks.
Consideration should be given to the availability of an

30 https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-
20355751
31 https://www.contemporaryobgyn.net/view/hypertensive-disorders-pregnancy
32 https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/
optimizing-postpartum-care
33 https://www.contemporaryobgyn.net/view/hypertensive-disorders-pregnancy
34 Hypertensive disorders of pregnancy, May 10, 2018, Charlene H. Collier, MD, MPH, MHS,
FACOG, James N. Martin Jr., MD, FACOG, FRCOG, FAHA

Page 17