Right angle tear in uterus?

[~Kate~]

Hi Girls

I'm asking this question for a friend who is due in 7 weeks with her second child. She wants to go VBAC but has been told that due to a right angle tear in her uterus after an emergency c/s with her first child (Aug 07) that it is not advised.

Apparently, because the tear runs down the uterus it could cause a rupture and the risk of losing the uterus and no more kids (which she wants at least 4)

Can anyone help me out with some info on this? We've tried google but have not had any first hand account of someones experience with this.

TIA

[veebee2]

Have you checked childbirth connection website? That may have some useful info for you.

[Snacks]

Hi Kate. I'm sorry, I don't have any written information or links for you. However in everything I have heard about VBAC, I've consistently heard that women who have experienced "classic" cesareans (where the incision runs vertically down the uterus like your friend's tear) are at a far increased risk of rupture - a risk of up to 12% I believe? The midwifery today journal says this type of scar is a contraindication to VBAC. They also acknowledge that there is anecdotal evidence that some women have successfully birthed subsequent babies vaginally, though. But the stats are not great.
Certainly rupture can have devastating consequences for both mother and baby. Possibly your friend's best bet is to research risk of uterine rupture in women who've had previous classic cesareans?
All the best to your friend as she makes this decision.

[Astrid]

My first c-section was classed as a "complicated emergency c-section with tearing into the angles". Now I was never able to get anyone to explain to me what that meant, but it did not impact on me going for a VBAC 2nd time around. They were more concerned with things like had I gone into labour myself, how far dilated etc as an indicator where I would be suitable or not. Did not get a chance to have my VBAC due to another problem, so never got a chance to see how well my scar would hold up.

[~Kate~]

Thanks for the help girls...does anyone else know more?

[Snacks]

Is your friend's doctor willing to talk to her further about it? If s/he is approachable, perhaps they might be able to show her some research?
Alternatively, could your friend seek a second opinion?

[~Kate~]

They've decided to have a c/s cos they are unsure as to where the tear is or how big it was.
Thanks everyone