Quote:
Originally Posted by Norasmomma 
My Dr who is a very wonderful Dr was pretty grave about my incision, he told me that many women with a typical bikini incision have great successful VBAC(this has been a VBAC hospital, and women I know have had them here). He said due to the nature of my incision and the way he had to reattach everything my scar is much more fragile than the majority of women with c/s scars. I do have a higher chance of uterine rupture because of my scar. Time isn't a factor in this, it is because of the nature of my scar.
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I had a lot of stretching/pulling/itching sensation in the area of my horizontal scar (which is skin only, not the uterus) with my first 2 pregnancies, although they both ended at 10 weeks, so I don't know what it would've felt like further along. This time, I've felt more stretching/pulling at my laparoscopy belly button scar but not so much my horizontal scar.
From what I've read, yes you do have an increased risk of rupture with that particular type of scar. Also, the odds of finding a care provider willing to do a VBAC are slim, and for me personally, I'm not sure that I would risk it, but I don't know enough one way or the other. I think the challenge that you run into, like me, is that there aren't a whole lot of women with t-incisions, so there isn't a whole lot of information out there.
In terms of your scar being fragile, I can only offer from what I've read and heard along my own journey. No doc can really know how a scar has healed or the strength of it. The tricky thing with scars is that they're strong, but they lack mobility. They're designed to keep together what has been taken apart and the types of fibers that form scar tissue are quite strong, but their "weakness" is lack of elasticity. Which when it comes to labor and contractions can be a liability. Keep in mind though that there is a difference between a true uterine rupture (defined as a full-thickness separation of the uterine wall and the overlying tissue) and uterine scar dehiscence (separation of a preexisting scar that does not disrupt the overlying visceral peritoneum (uterine serosa) and that does not significantly bleed from its edges). From what I've read, most "ruptures" with a previous scar involved are uterine scar dehiscence (very rarely has a catastrophic outcome) vs. a true rupture.
I had one doc who wanted me to do steroid injections at 24 weeks in case I ruptured, I had another doc tell me my uterus would "split wide open" if I had a single contraction. Unfortunately, none of the the docs I have consulted with have been willing to look at the research I compiled that shows that a small number of women have indeed had a vaginal birth after the surgery I had and that none of them ruptured. Does this mean there isn't an increased risk of rupture? No, but I definitely don't believe a contraction is going to split my uterus wide open.
I think the majority of docs really do believe that having an unusual scar is a huge risk. They're scared and they're wanting the best outcomes and have to be mindful of covering their assets so to speak. I don't fault them for that, but I also think their actual knowledge of unusual scars isn't great because they have such a reactive approach to them. They're not going to risk finding out how a classical scar or a t-incision or a myomectomy scar reacts under the stress of labor when in their minds it's a no-brainer to do a c/s and avoid any risk of rupture.
All of that to say, I don't think your risk of rupture during pregnancy is any higher than mine. I would imagine, if anything, it's lower, because your incision is lower (depending on how high up the vertical portion went) and the lower part of the uterus isn't stretching and expanding as much during the pregnancy.
I did stumble across
this website when I googled "t incision cesarean". It looks like they have a yahoo group for women with inverted t-incisions and some research results. Hope that's of help.
