Trial of Labour

Olaniyan Olajumoke - 198648

Trial of Labour
Trial of labour is the conduction of spontaneous
labor in a moderate degree of disproportion, in an
institution under supervision with watchful
expectancy hoping for a vaginal delivery. It is a test of
labour allowing the patient to enter into active
labour putting all variable (power, passage and
passenger) into test and determine whether vaginal
delivery is possible or not.
TOLAC
Trial of Labour after caesarian section (TOLAC) and it refers
to a planned attempt to labour and delivery vaginally by a
woman who has had a caesarian section in the past. It
differs from Vaginal birth after caesarian (VBAC) delivery in
that not all trial of labor may result in vaginal delivery.
Trial of labour after caesarian (TOLAC) is a planned or
attempted vaginal birth after caesarian (VBAC) .
Sometimes ,there is a need to change the plan,and a
TOLAC results in caesarian birth after caesarian (CBAC). A
birth is officially considered a VBAC ok once the TOLAC
results in a vaginal deficiency.
Indications for Trial of Labor
• Previous elective caesarian section with no prior complication.
• Previous lower segment transverse caesarian and no complications after
caesarian section.
• Single pregnancy with vertex presentation
• Multiple pregnancy with vertex-vertex presentation
• No history of myomectomy
• Other favourable factors influencing labour (power, passage, passenger) I.
cases of maderate disproportion
• The availability of anaesthesia and personnel for emergency caesarian delivery
• Full understanding of risks of Trial of labour after caesarian when necessary.
• Presence of physician immediately available throughout active labour who is
capable of monitoring labour and performing an emergency caesarian delivery.