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A 32-year-old second gravida who had an LSCS in her first pregnancy is admitted in labor. The fetus is in the cephalic presentation. The head is engaged. This estimated fetal weight is 3 kg. Uterine contractions are 2 per 10 minutes. The fetal heart rate is 140 bpm. The cervical dilation is 5 cm. The vertex is felt 1 cm above the ischial spines. The posterior fontanelle is felt. Pelvis is adequate. The membranes are intact. What is the best management option?

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Correct Answer:
Do an amniotomy and allow labor to progress
Description:
Ans. is a, i.e. Do an amniotomy and allow progress of laborIn this case, all findings are suitable to allow VBAC. This patient is 5 cm dilated. Contractions are 2 in 10 minutes i.e. inadequate. Adequate contractions are 3 in 10 minutes. Hence logically augmentation of labor should be done. In previous LSCS patients augmentation should be done by doing ARM i.e. amniotomy and oxytocin should best be avoided.
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