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Incision extension - consequences for vbac

2K views 5 replies 5 participants last post by  azzeps 
#1 ·
I had a repeat c-sec last month after a vbac attempt. I got to full 10 cm dilation after 60 hours of labor but then contractions petered out, baby was still at zero station, and doc just didn't want to wait anymore.

Later the doc told me that the 4.5 inches incision she'd made on the uterus got extended on either side by a centimetre or so as she was digging in to get the baby's head out of my pelvis. So my incision tore a little on either side, making incision size about 5 inches or so. She said she was afraid the tear would extend into the uterine vessels, but thankfully that didn't happen, and the c-sec was complication-free. I had a smooth and uneventful recovery.

Apparently extensions of the incisions are more common at full dilation and when baby's head is low. I'm wondering whether this will have any bearing on any subsequent pregnancy and chances for future vbac. Will it increase my vbac risk?

Anyone who had incision extension with a prior c-sec and went on to successfully vbac?
 
#2 ·
Me! I had extensions on both sides heading down towards my cervix. Since they went down and not up, there were no concerns. The ob who did the surgery (who is very much not vbac friendly.. I didn't choose him, he was on call) tried to scare me and basically said me and my baby would die. I collected my records and had him explain to me very clearly what my incision was like, including drawing diagrams. Then I took that to another ob whose opinions I trust, for a 2nd opinion. She said it was fine, no big deal, and as a surgeon, seeing that after a long labor with lots of pushing isn't unusual at all! She said that she would absolutely offer me a vbac. I went on to have 2 vbac babies at home, 10 and 11 lbs, and my uterus stayed nice and strong through even 4 hours of pushing with my big one.

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#4 ·
I've also heard that extensions are not unusual in somebody who has completely dilated. During my second csection, after pushing for 3 hours, my incision extended downward toward my cervix, on one side. The ob who did the surgery told me I should never labor again. When I got pregnant I sought a second opinion and was considered to be a good candidate for vba2c by that dr. Just a little over a week ago I had a successful vba2c
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#5 ·
Quote:
Originally Posted by hannybanany View Post

I've also heard that extensions are not unusual in somebody who has completely dilated. During my second csection, after pushing for 3 hours, my incision extended downward toward my cervix, on one side. The ob who did the surgery told me I should never labor again. When I got pregnant I sought a second opinion and was considered to be a good candidate for vba2c by that dr. Just a little over a week ago I had a successful vba2c
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congratulations!!!~~~

I had a c-sec after 3 hours of pushing (it was an emergency, so they moved quick... I'm sure I had some tearing.. they even had to push the baby back up into my abdomen from below (vaginally) because he was so wedged in my pelvis. I went on to have two natural complication free VBACs. :)
 
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