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16 October 2008 @ 11:48 am
Uterine rupture rates in VBAC patients who received classic cut - NOT tranverse cuts...  
I know that generally a trial of labour is less risky than a repeat c section. However, most of my research is focused on women with newer style low tranverse bikini cuts (as indeed mine was). But I have a friend who received the classic cut (goodness knows why) which goes vertically from the belly button to the bikini line. She was told that she'd never be able to birth vaginally and that she would always need c sections. My first thought that it was a fallacy, because all of my research about VBAC has suggested otherwise. I just think her doctor is not very VBAC friendly and seemed a bit too c section endorsing to me. I thought that a HBAC would probably be out as she'd need to be more carefully monitored. I'm assuming that dehiscense (sp?) and ruptue rates are higher in women who have been cut in this way, however I'm still sure that a vaginal birth would be possible if she was to receive monitoring and no augmentation/induction drugs (which I know increase the risk of uterine rupture). I've told her my belief however I would like to make sure I'm giving her the right facts. If it's blatantly impossible/very dangerous for a woman who'd received a classic cut to try for a vaginal birth it'd be good to find out.

I'd really love to find some research to show her. If she was happy to have repeat c sections I'd not bother, because I don't like to press my opinions on other people. I'll give them information but don't want to pressure them. However, she has expressly said that she would love a natural birth and I really want to find out if that's possible.

Please forgive me if this is the wrong place to post this.

Morphinae: Rowan - WTF?morphinae on October 16th, 2008 01:23 pm (UTC)
There is an elevated risk compared to a VBAC with a lower transverse scar. Personally I don't find it to be an astronomical figure, but that's something she's going to have to research and evaluate for herself. Here's some info taken from http://www.vbac.com/uterine.html :

Rarely, a woman may have a classical (vertical) scar in the upper part (the body) of the uterus. This type of incision is used for babies who are in a breech or transverse position, for women who may have a uterine malformation, for premature babies or in extreme circumstances when time is of the essence.

The risk of rupture for this type of scar has been reported to be between 4% and 9%. A classical scar on the thinner and more vulnerable part of the uterus tends to rupture with more intensity and result in more serious complications for mothers and babies. Mothers who have had several children and have a classical uterine scar are at higher risk for uterine rupture.