[chlorita]

can someone tell me what this is exactly?

thanks!

 

[citymama]

It is a separation of the scar from your prior cesarean, also called a "window". In a small percentage of women (less than 1%), the scar can start to separate during a subsequent labor. Lots of OBs talk about "uterine rupture", but my understanding is that the statistics for URs make no distinction between a true UR and a dihesence. Also, women without prior cesareans can experience a UR.

 

[egoldber]

Quote:

Originally Posted by citymama but my understanding is that the statistics for URs make no distinction between a true UR and a dihesence

This is true for some studies, but some do make the distinction and provide UR rates that do not include dehiscences. One of these is the 2004 December NEJM article.

http://content.nejm.org/content/vol3...25/index.shtml

 

[citymama]

i'd be curious to read. are you a subscriber? can you post it? tia.

 

[egoldber]

The full text is available online for free. Click on the link in my post, and select the article titled "Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery".

 

[wifeandmom]

Here is what the 'Results' section from the article mentioned above says:

Quote:

Vaginal delivery was attempted by 17,898 women, and 15,801 women underwent elective repeated cesarean delivery without labor. Symptomatic uterine rupture occurred in 124 women who underwent a trial of labor (0.7 percent). Hypoxic-ischemic encephalopathy occurred in no infants whose mothers underwent elective repeated cesarean delivery and in 12 infants born at term whose mothers underwent a trial of labor (P<0.001). Seven of these cases of hypoxic-ischemic encephalopathy followed uterine rupture (absolute risk, 0.46 per 1000 women at term undergoing a trial of labor), including two neonatal deaths. The rate of endometritis was higher in women undergoing a trial of labor than in women undergoing repeated elective cesarean delivery (2.9 percent vs. 1.8 percent), as was the rate of blood transfusion (1.7 percent vs. 1.0 percent). The frequency of hysterectomy and of maternal death did not differ significantly between groups (0.2 percent vs. 0.3 percent, and 0.02 percent vs. 0.04 percent, respectively).

Overall, the study found that ERCS was safer for both mom and baby in comparison to attempted VBAC, *however* the actual numbers were very low for BOTH choices.

The entire article is fascinating and certainly worth registering to read (it's free to do so). The charts that are included in the article are worth registering for alone, as they break it down into all sorts of interesting things.

 

[citymama]

Quote:

Originally Posted by egoldber The full text is available online for free. Click on the link in my post, and select the article titled "Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery".

I did try, but you have to register and free registration gets you articles published in the last 6 months.

 

[egoldber]

Really? I certainly never paid anything, LOL! If I did register it was years ago and I never log on. Actually I thought that you had to pay if you wanted articles published within the last 6 months. The article I referred to was in December 2004.

This is a link to the main page.

http://content.nejm.org/

Go to:
Past Issues
2004
under December, click on issue 16

If that doesn't work I'm stumped. Its always worked for me.

 

[wifeandmom]

Quote:

Originally Posted by citymama I did try, but you have to register and free registration gets you articles published in the last 6 months.

I'm pretty sure it's free access to articles published OVER 6 months ago.

I registered for free and read the entire article after the link was posted here in this thread, so it definitely works.