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Old 07-19-2013, 02:50 AM   #1
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TOLAC after uterine rupture

I just wrote a long post, and the app just ate it when it timed out (I hate that it won't "give" you the post back like FB does).

Shortened post: is it safe to attempt a TOLAC when your last TOLAC resulted in e-c because of suspected uterine rupture, and during the c it was confirmed that the uterus was barely holding together and on the verge of rupture?

My brain says no, it would be the same as any other vba2c situation. But I also didn't know until my first pregnancy that VBAC was a "thing," or that some places dont let you. I thought you at went and tried for another vaginal birth after a csection. So I am trying to arm myself with knowledge now, before we start TTC (its still a few years off).

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Old 07-19-2013, 05:12 AM   #2
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I would think that it just depends on your body and your OB's comfort. I'm planning on trying to deliver this baby vaginally but will have to be open to c-section as I have had prior uterine surgery. From my conversations with my OB, he determines it based on where the weakness/scars are on the uterus and the nature of them, how successful you were on delivering vaginally/without induction or pharmaceutical help and general health.

Honestly, if you have already had two c-sections and you were close to rupturing on the last one, I would just ask for c-section. It just doesn't seem worth the risk to me, but that is just me. Uterine rupture terrifies me, personally.

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Old 07-19-2013, 05:34 AM   #3
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Re: TOLAC after uterine rupture

If I had ruptured, one of us would have likely gotten "fixed" permanently. I would not attempt another vaginal birth.
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Old 07-19-2013, 05:36 AM   #4
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Short answer- not recommended. Some specialists recommend repeat Cesarean at 36 weeks in women with previous documented rupture. If it was a uterine window (not ruptured but close) I would talk to your doctor about what is safest for you and baby (probably cesarean). I love VBACs and fortunately uterine rupture is rare, but when it happens we take it very very seriously.
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Old 07-19-2013, 05:37 AM   #5
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Re: TOLAC after uterine rupture

In my research during my last pregnancy a uterine window was a contraindication for a vbac. Even a book by Ina May Gaskin mentioned this would be a reason to refuse a home birth.

In your situation I wouldn't risk it.
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Old 07-19-2013, 09:54 AM   #6
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Absolutely not.
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I'm so tired of hearing about how important a birth is. It is absolutely nothing more than an obstacle between a family and a baby.
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Old 07-19-2013, 09:58 AM   #7
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Quote:
Originally Posted by lynn97
I would think that it just depends on your body and your OB's comfort. I'm planning on trying to deliver this baby vaginally but will have to be open to c-section as I have had prior uterine surgery. From my conversations with my OB, he determines it based on where the weakness/scars are on the uterus and the nature of them, how successful you were on delivering vaginally/without induction or pharmaceutical help and general health.

Honestly, if you have already had two c-sections and you were close to rupturing on the last one, I would just ask for c-section. It just doesn't seem worth the risk to me, but that is just me. Uterine rupture terrifies me, personally.

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Is that something that can be determined through ultrasound? I don't remember them saying they could see it, but my last hospital I don't think they really said anything about what they were checking other than heartbeat or estimated size of baby.
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Old 07-19-2013, 10:02 AM   #8
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Originally Posted by dudleypippen
Short answer- not recommended. Some specialists recommend repeat Cesarean at 36 weeks in women with previous documented rupture. If it was a uterine window (not ruptured but close) I would talk to your doctor about what is safest for you and baby (probably cesarean). I love VBACs and fortunately uterine rupture is rare, but when it happens we take it very very seriously.
I'm not sure if it was a window. I was never told that term, but maybe. The doctor did say it was very close to rupturing, and was barely holding together. He said it was very thin where it was barely hanging on, so thin he removed that part completely because it wouldn't withstand another pregnancy, and stitched it together where it was thicker.
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Old 07-19-2013, 10:03 AM   #9
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Re: TOLAC after uterine rupture

Having already ruptured your rate of re-rupture is profound. I would not attempt a vbac in this instance and personally I would be hesitant to even get pregnant again.
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Old 07-19-2013, 10:04 AM   #10
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Originally Posted by qsefthuko
In my research during my last pregnancy a uterine window was a contraindication for a vbac. Even a book by Ina May Gaskin mentioned this would be a reason to refuse a home birth.

In your situation I wouldn't risk it.
Home birth has never been an option for me. I mean, yeah, technically it is, but it is outside of my comfort level and not something I have ever had any desire for. I will consent to a RCS before intentionally attempting a home birth.
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