Vaginal Birth After Cesarean Delivery (VBAC)

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Choosing a vaginal delivery after a C-section can be a safe and appropriate choice for many women. Studies have shown up to a 60-80% success rate for women who attempt VBAC. However, it is a very personal decision, as neither VBAC or repeat C-section are 100% free of risk or complications. It is very important for all patients considering a VBAC to carefully weigh the risks and benefits.

VBAC is recommended by the American College of Obstetricians and Gynecologists. More information can be found here:

Who is a good candidate to attempt a VBAC?

A patient who has had 1 prior vaginal delivery with a normal incision on the uterus (side to side, or “low transverse”) is a good candidate for VBAC. Your prior hospital records will be used to confirm the location of the uterine incision, as your scar on your abdomen frequently may not be the same as the scar on the uterus.

Who is not a good candidate for VBAC?

Any of these complications may increase the risk of uterine rupture:

  • History of multiple C-sections
  • Vertical or “classical” incision on the uterus
  • Medical complications including but not limited to diabetes, hypertension, preeclampsia

What are the benefits of VBAC?

Your future plans for more children may impact your decision. Because C-sections become more risky with each subsequent surgery, you may want to consider VBAC if you plan to have a large family. Other benefits include:

  • Avoiding major surgery
  • Decreased recuperation time and hospital stay
  • Decreased risk of blood loss or infection

What are the risks of VBAC?

The main risk of VBAC is a small risk of uterine rupture or a tear in the wall of the uterus. This happens in less than 1% of appropriately selected patients. If uterine rupture were to occur there is an increased risk of:

  • Emergency C-section
  • Blood transfusion
  • Hysterectomy
  • Fetal injury or stillbirth

What are the risks of repeat C-section?

  • Increased risk of blood loss, infection, injury to adjacent organs
  • Abnormal implantation of the placenta requiring preterm birth, blood transfusion, or hysterectomy
  • Increased recuperation time and hospital stay

You can use the Maternal-Fetal Medicine Unit Network Calculator to see your own calculated success rate based on age, BMI, and other prior history: Evidence suggests that women with at least a 60–70% chance of successful VBAC have less risks for VBAC vs. C-section. However if your chance of success is less than 60%, the risks of VBAC may outweigh the benefits.

What increases my success rate?

  • Prior vaginal delivery or VBAC
  • Spontaneous labor
  • Age less than 35
  • Prior C-section for breech position or fetal distress

What decreases my success rate?

  • Need for induction
  • Delivery after 40 weeks gestation
  • Age over 35
  • Obesity
  • Prior C-section for failed induction
  • History of large baby or current large baby
  • Patients who delivered prior baby less than 1 year ago

Please discuss VBAC with your doctor during your visit. Your doctor will help you evaluate your personal risk and chance of success and guide you though the process. If you and your doctor decide to attempt a VBAC, it is important for all patients to realize that your health and your baby’s health is the most important priority to all the physicians at Advanced Ob-Gyn Associates. While we want to provide every patient with their desired birth experience, all patients must be prepared to make changes as necessary to keep them safe. 

Best OBGYN in Dallas

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The best OBGYN in Dallas TX

Why is Advanced OB GYN the best choice for me?

Turn to Advanced OB GYN Associates of Dallas for their reputation as one of the best practices in the Dallas area. The best Dallas gynecologists are waiting for you at AOA.

When looking for your first gynecologist or a new one, trust the professional physicians at AOA to ensure you are treated with care and respect.

Expert Obstetricians

At AOA the best Dallas OB GYN’s are available to help you through some of the most difficult times in your life, from puberty to child bearing to menopause; our caring Obstetricians and Gynecologists can the answers you are looking for.

Cutting Edge Technology at Advanced OBGYN

AOA is not only known for our caring staff. With cutting edge, minimally invasive robotic surgery among the many options available at the clinic, you can be assured that you have the most effective options available to you. With leading procedures in cervical cancer screening, infertility, 4D sonographic imaging, the Leep procedure and even heavy period solutions, our team is backed by some of the best technology in the field today.

Best Dallas Gynecologists

With leading OB-GYNs serving the Dallas area you can be assured of a caring solution that goes above and beyond a “traditional” doctor visit. Meet our team of professionals:

Dr. Richard Salter is one of the most well-known OB-GYNs in the Dallas area as seen frequently on Dallas News stations and on the popular “Top Docs of DFW.” With experience spanning two decades Dr. Salter is the resident expert for high risk obstetrics, infertility assessment and treatment and early stage gynecologic cancer surgery.

Total Care Solutions for women

Whether you are looking for solutions for infertility, common gynecologic maladies or worried about cervical cancer, our full team of the best Dallas Gynecologists have all your bases covered.

Come visit the best, come visit Advanced OB-GYN & Associates in Dallas for your OB-GYN needs today.

After Tubal Ligation

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After Tubal Ligation

After Tubal Ligation Surgery: Symptoms and Side Effects

There are many reasons that a woman may choose not to have children or not to have any further children. Regardless of the reason, tubal ligation surgery is usually the answer to resolve this very personal decision. Although, this type of surgery is not considered to be life-threatening; there are some potential symptoms and side effects that the patient should be aware of.

What is Tubal Ligation?

The tubal ligation procedure is used to block the fallopian tubes. This keeps any eggs from going down the fallopian tubes from the ovaries and into the uterus. Sperm will not be able to reach the ovaries as well, further decreasing the chance of pregnancy. This often irreversible solution is perfect for those women seeking a permanent birth control method.

Side effects of getting your tubes tied?

Bleeding and Infections – Some women may have excessive bleeding or infections after the surgery. This is common with many surgeries, and often requires further medical attention, depending on severity.

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Screen for & Prevent Cervical Cancer

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Prevent Cervical Cancer


According to the American Cancer Society, over 4000 women will die from cervical cancer this year. While cervical cancer was once the leading cause of cancer-related deaths in women, numbers are quickly decreasing as prevention techniques are improving. Regular tests can help women catch cervical cancer warning signs early on and adjust their lifestyles accordingly. Early testing can also help lead to early cancer treatments, improving the odds of survival. Use these techniques to help prevent the spread of cervical cancer.

Reducing Your Cancer Risks

Reducing your risk of cancer can be as simple as changing your eating habits. While some other lifestyle choices can increase your risk, such as smoking, a healthy diet can be one of the most proactive actions you can take. Avoid foods that are known to cause cancer and follow a healthy diet plan. Regular exercise can also help to reduce your risk of cancer.

HPV infections can also lead to more serious forms of cancer. Using condoms during sex and limiting the number of sexual partners a person has can reduce their risk of exposure. While HPV infections can occur in both covered and uncovered regions, using a condom can still reduce your risk overall. Read more »

Pregnant at 40 | Tips for delivering a healthy baby

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Pregnant at 40? Tips for delivering a healthy baby.

Pregnant at 40

Pregnancy is a memorable time in the life of a woman, and can sometimes be a stressful time as well. Questions about infertility often arise for women who are trying to get pregnant after 40. There are quite a few factors that contribute to fertility difficulties after 40, including illness, lifestyle factors such as smoking and obesity, stress, and diet.

At Advanced OB GYN Associates near Plano, TX, we help women who are enduring fertility challenges. Consulting professionals, like the experts at Advanced OB GYN Associates, can help relieve the strain from women and couples during this stressful time. In the meantime, we have compiled a few tips to get you started and help you maximize the chance of having a healthy baby.

Here a few tips to getting pregnant at 40+:

Change your lifestyle

Getting your body ready for a baby is like preparing a nursery: the environment you provide must be as clean and healthy as possible. For those who smoke, this is the time to stop. Staying fit by maintaining a healthy weight and reducing your level of alcohol consumption are also of paramount importance.

Visit a great doctor like the fertility experts at Advanced OBGYN

If you are 40 or older, and you are having unprotected sex with your partner two to three times a week for about three months, and there are no signs of pregnancy, see a doctor or infertility clinic. Blood tests may help discover if there are any medical reasons preventing you from conceiving.

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Should My Daughter Get the HPV Vaccine?

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Should My Daughter Get the HPV Vaccine?

The answer is yes, she should get vaccinated, and so should your son. The HPV vaccine, which prevents infection from the cancer-causing Human Papilloma Virus, is essential. Some parents may not see the need for the vaccine. They’re worried it’s not safe, or they think their kids don’t need it because they’re not sexually active, but HPV now affects over 79 million people and it is very possible to contract the disease without engaging in what many parents consider to be sexual activity.

Increased Promiscuity after HPV Vaccine Concern

While many parents have expressed concerns that a vaccine will promote sexual promiscuity, the truth is, HPV can infect the mouth and be passed orally. Because there is a greater concern that HPV can be passed through kissing, parents want to be sure they understand the increased risk.

The Risk of HPV from Kissing

HPV used to be something that people ignored, but the virus now affects millions. While children aren’t sexually active, they can still get the virus from kissing. Some moms are even blogging about the need for the vaccine given and the growing concern over mouth cancer.
Teens and preteens can contract HPV from kissing. If for example they kiss someone with HPV, this can then be unknowingly passed onto them. When Michael Douglas contracted mouth cancer from HPV, WebMD used this as a reminder that we must take preventative measures.
Most young men and women show no symptoms of having HPV. It can also clear up after 2 years without medication. Unfortunately, carriers of the virus have a much higher chance of getting:

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Best Time for 3D Sonograms

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Best Time For 3D Sonograms

When is the Best Time for 3D Sonograms?

3D sonograms are three-dimensional images produced by an ultrasound device, a machine emitting sound waves that rebound off internal organs, muscles and bones. By calculating the distance between sound waves, ultrasound-based sonograms generate accurate, lifelike images that are then displayed on a computer screen so the doctor and patient can view what is occurring inside the body.

Best Timing for 3D Sonograms

Primarily used on pregnant women for clinical and personal reasons, 3D sonograms may be given to “see” the fetus as early as 13 weeks, although features of a fetus are not clearly discernible at this stage in a pregnancy. To fully enjoy the benefits of a 3D sonogram, obstetricians at Advanced OB GYN recommend patients receive their first 3D sonogram when they are between 24 and 32 weeks pregnant.

Seeing Your Baby for the First Time in 3D Sonograms

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Common Causes of Female Infertility

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The Top 5 Common Causes of Female Infertility

By administering medications to regulate hormone levels or performing minimally invasive surgery to remove or repair whatever is causing female infertility, the professionals at Advanced OB GYN Associates can help you get to the root cause of your infertility and dramatically increase your chances of enjoying a full-term pregnancy.
What May Be Causing Your Infertility?
The five main reasons women experience infertility or have trouble carrying a pregnancy to term (excluding age) are:

1. Ovulation Disorders is the highest cause of woman infertility

Women who ovulate infrequently or rarely at all comprise nearly 30 percent of infertile couples. Ovulation disorders are commonly caused by irregular production/release of reproductive hormones manufactured by the pituitary gland or hypothalamus, or issues with the ovaries independent of glandular problems. Polycystic ovary syndrome, premature ovarian insufficiency and excess prolactin in the bloodstream are a few ovulation disorders frequently diagnosed by doctors at Advanced OB GYN Associates. Read more »

Switching Birth Control

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How Does Switching Birth Control Affect Your Health?

Birth control methods using hormones to inhibit ovulation come in pill or patch form. For this kind of birth control to be effective, both the pill and patch must be used consistently. Removing the patch or forgetting to take the pill for one day significantly increases the risk of pregnancy.

If you are using the pill or the patch and switch to another form of birth control, your health will be affected in the following ways:

  • Progestin and estrogen levels return to normal so that ovaries can release an egg.
  • Initially, your periods may become heavier and last longer but should return to normal in two to three months. If you experienced lessening of premenstrual symptoms while taking the pill/patch, cramping, headache and bloating may worsen as well.
  • The risk of developing ovarian or endometrial cancer increases when you stop using hormonal birth control.
  • For women who experienced breast enlargement/tenderness, bleeding between periods or amenorrhea (cessation of menstruation), these symptoms should eventually disappear.
  • It is not uncommon for women to report loss of libido while using hormonal birth control. Once estrogen levels return to normal, interest in sex usually returns.
  • Of course, the greatest change in your health is being fertile again, at least until you begin using another form of birth control.

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Prenatal Yoga Richardson

Prenatal Yoga: The Best Exercise for Pregnancy

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My pregnant patients always ask me: “Can I exercise while I am pregnant?” The answer is, yes, yes, yes! There are certain medical conditions related to pregnancy which may not allow you to exercise, such as placenta previa, an incompetent cervix, history of preterm labor, severe hypertension, or a multiple pregnancy like triplets. If you don’t have any risk factors, than prenatal exercise is for you.

In my opinion, one of the better exercises is prenatal yoga. The reason is because yoga helps you with three basic things that can influence pregnancy: flexibility, mental stability and focused breathing.

Prenatal yoga has countless proven benefits. It helps you with sleep, which most of my patients complain about. It increases muscle strength, relieves nerve compression that causes back pain and it improves overall cardiovascular performance which helps the baby grow more effectively. In addition to physical benefits, prenatal yoga helps with stress and anxiety. The key is finding an instructor that is well versed in these types of exercises.

As you probably know, there are many different kinds of yoga poses, but there are a few that have been found to be especially beneficial for pregnant women: Read more »