Bandl's Ring aka abnormal retraction ring

[Cian'sMama]

Hi Mamas,

I am wondering if anyone else has had a Bandls' Ring. In my quest for healing from my vba2c turned repeat cesarean birth I am trying to read what I can on what this is, and sadly I can find very, very little information. Can anyone help?

Thanks!

[Cian'sMama]

Isn't there anyone out there?! Please share!

[Cian'sMama]

I know this is a pretty rare thing...still I am surprised that no one has had this! Thought I'd try again....

anyone? anyone know anyone who had this?

thanks!

[mwherbs]

It is rarely seen anymore because they do c- sections fairly quickly. There is a division zone between the lower segment and the upper segment, a bandl's ring develops in this area it is thought to be associated with impending uterine rupture caused by obstruction that zone becomes thinner and thinner and just above it becomes thickened so you can feel and sometimes see it

The one I know about the baby had both hands at the back of the shoulders with elbows presenting along side the head,in the Victorian era pelvic deformity was a cause of obstruction

[Hemmal]

I had a c-section after a HBAC attempt; After the surgery (8/26/10) the OB told me that I had developed a Bandl's Ring, but I never could find anyone else that had ever had one or much information at all on these rings.

[Cian'sMama]

Thanks for the replies! Interesting about the c-sections happening more quickly these days, I hadn't thought of that. In my case it was very obvious, my stomach literally looked like an hourglass. I thought it was bizarre and mentioned it to my MW but she thought nothing of it. A nurse saw it and asked me about it, saying that it looked strange. I told her I agreed, but that no one seemed concerned. I am surprised because it now seems very obvious to me. Anyway, again my thanks for the replies...it is somehow comforting to hear of someone else who either knows about it or has been through it.

Peace!

[Devaskyla]

This is a really good article about Bandl's ring http://womantowomancbe.wordpress.com/2009/11/03/bandls-ring/

[carolla143]

I just had my daughter and after laboring naturally for 24 hours my OB could see the Bandl's Ring just looking at my belly. :( Off I went to a c-section. I realized it was rare when during the surgery he made sure to point it out to all the other medical people in the room. At my post-op appointment I intended to ask him about it, particularly if it would affect my ability to delivery vaginally in the future. He wasn't the one who did my post-op appointment and the NP that did it didn't know anything about a Bandl Ring. Soo...I'm waiting for a call back from the OB or from her to give me more information. I'll post again if I get any good/worthwhile information.

I was soo disappointed to have to end up with a c-sect but of course would prefer that over uterine rupture, etc etc etc. I had never heard of it before either.

[Pock29]

Hi Ladies.

   I am also one of those women who have suffered from a Bandl's Ring back in 2010 with my daughter. Naturally hoping for a smooth progressing labor, it turned to be far from that. I am currently looking into trying to conceive again and have been trying to do some more research on how this may affect me trying to have another. As far as I know from what my past doctor had told me about a Bandl's Ring, it is not a common thing. My doctor had told me that he had only seen one other in the 33 years he had been a Doctor. I had labored for 3 days, consistanly going back and forth to the Hospital from contractions and every time they had sent me home. I was dilated 3 for days before but due to the fact I was not progressing they said they could not keep me. Finally after my water broke they had no choice. I was given medicine to kick start my Labor but it was slow. After a Epidural, and even more hours I finally had made it to a seven and stopped dialating. The baby's heart rate dropped, she was stressed and so a C-Section was schelduled. Unfourtanlly during the procedure I was able to feel what was being done to my body and feeling my child move. It was a scary feeling but they were finally able to knock me out and contiune getting the baby out. My husband at this time was asked to leave the room after seeing the baby, and after the fact he told me what had happened. It took them hours after getting the baby out to finally wake me, and once I did the Doctor told me I had a Bandl's Ring. The information he gave me was as follows. Ishould not be able to have a VBAC due to a high chance of rupture. I will not be able to go past 36 weeks in a future pregnancy, and even though it's not guarenteed, he stated that the ring will most likely develop again next time. I do not know of anyone beyond forums that suffered from a Bandl's Ring, but the information I've found there is still scarce. Hoping time will tell as they may be able to find some more information on this condition in the future...

Sites that I have found include..

http://www.jrank.org/health/pages/30424/retraction-ring.html

http://womantowomancbe.wordpress.com/2009/11/03/bandls-ring/

http://www.babyworld.co.uk/faq/individualfaq.asp?Section=Labour+and+Birth&SubSection=Labour&query=&opt=&page=&question=2596

http://www.mothering.com/community/forum/thread/307869/need-info-about-bandl-s-ring-and-vbac

[miriam]

http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x5609.html

http://www.ncbi.nlm.nih.gov/pubmed/8155216

http://en.wikipedia.org/wiki/Ludwig_Bandl

[BexB]

Hi. I had a bandl's ring which resulted in a traumatic c section with a wonderful result because my son is alive and healthy. 

[tarnsnzl]

Hi there. I have a True Bandl's Ring - a condition so rare my surgeons were extremely excited when they opened me up for an emergency c-section (apparently they'd read about it but had never actually seen one in real life).

Basically what they told me is that you have two lots of uterine muscles.  The top lot push the baby down.  The bottom lot open up the cervix.  Where these two groups of muscles meet is the Bandl's Ring and in my case when I go into labour rather than this band expanding (like 'normal' people), it gets tighter and tighter, pushing the uterus into an hourglass shape, resulting in uterine rupture. 

This combined with the fact my pelvis is too small to fit a baby out, means 50 years ago we would have been gonners.

Anyway, having this condition means that for subsequent babies I have had to be booked in for an elective c-section a week before their due dates so I don't go into labour (I am not allowed to labour AT ALL),  and should I happen to go into labour early, I have been advised to get to the hospital ASAP.

I have had two more children since my first.  All elective c-section (obviously) and have no problems.  In fact my last surgeon said that I have very little internal scar tissue.  The scar tissue rubbing on the internal organs is the main reason why they try to not encourage any more than 4 c-sections but I do know someone who has had 7.

Recovery with each has been great - been up and out of bed the next morning even though hospitals here in New Zealand keep you in for 3 nights/4 days.

The only thing I've found is that a lot of midwives don't want to take you on because they don't really understand the condition (I've made a point of taking my medical records with me so they understand) and explaining it in basic terms like those above.  I had to go through the hospital midwives for my last pregnancy as I moved towns. 

Wishing you all the best and if you have any questions, don't hesitate to ask - I'm not a doctor lol, but I may be able to help.  :)

[MreeG]

I too have had a Bandl's retraction ring, I was told by the doctors and midwives at the time that I was the second person they had ever seen with one. I still don't fully understand exactly what it was and my child is nearly 3 now.  Just really glad to read some of your views on it, as I was advised not to have anymore children.  They ruptured my womb and then 6 days later I haemorrhaged and ended up having 3 units of blood. Haven't been able to get much info off of the Internet or from any doctors.  I had to have an emergency c-section with my first child too after pushing for 4 hours and have now been told that I have a boy shaped pelvis and would never get a baby through it.  Would love to hear whether anyone else has any views on this or knows anymore info.

[Haelmoon]

Bandl's ring, as described above overs in labour.  It is not a uterine anomaly, and it does not always recur.  It depends what was the precipitating factor leading to a prolonged, but obstructed labour.  Rarely, they can occur at the time of C-section, which is a bit of a nightmare, because it can become difficult to deliver the baby as the ring is just above the incision, and can trap the body after the head is out (or head if the baby is breech and the body is delivered).

The reason patients who have had a Bandl's ring are recommended to have repeat and early C-sections, is often there is significant trauma to the uterus in the attempt to safely deliver the baby.  No infrequently, an inverted-T incision is made, which carries a much higher risk of rupture in subsequent pregnancies.  Occasionally the vertical component is extended close to the uterine fundus, which is functionally a classical uterine incision.  This carries a real risk of pre-labour rupture (1/3 of ruptures associated with classical incisions).  That is often the reasons for a early, repeat c-section.  However, if the ring was associated with non-recurring factors (advanced labour with fetus in a transverse position), and no vertical incision is made in the uterus, there would likely be a reasonable success rate for trial of labour in an attempt to VBAC.

It is true these are not seen commonly, mostly because obstructed labours are identified and addressed.   This does not mean there is always a C-section, but rather contributing factors relating to labour dystocia can be addressed in a timely fashion, reducing the risk of harm to mom or babe. 

To all moms describing there experiences, I understand it can be a very traumatic experience, physically and emotionally.  I wish all of you the best and hope your road to recovery is smooth.