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Re: Bicornuate and labor

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Mon, 17 Apr 2000 16:16:33 -0500 (CDT)

At Mon, 17 Apr 2000, Jennifer wrote: >
>Hello -
>I'm 37w 2d (thank goodness!) and I'm wondering about labor.
>I had a c-section due to breech with many complications my first
>delivery (almost 12 years ago). I will be attempting a VBAC this time.
>
>Given the following, can anyone with any experience give me some
>indication how labor will go? I know, it's different every time, but are
>there any things to be concerned about here? Anyone experienced a VBAC
>with any of these conditions? Was it successful?
>
>1.) Bicornuate uterus, with partial septum, fetus in right horn (where I
>carried my daughter to full term). The fetus is in a heads down and
>engaged position right now.
>
>Q - How effective is a bicornuate uterus in pushing the fetus out? Does
>this affect the ability to labor?

It shouldn't affect pushing. Important ot remember that the incidence of ruptured uterus following previous C/S is reported as about 1%. This will theoretically increase with uterine anomalies. No specific numbers available from studies.

>2.) LEEP procedure done 6 years ago to remove portion of precancerous
>cervical tissue. No complications afterwards.
>
>Q - I truthfully didn't even think of this before (I'm not sure if my OB
>knows about it!) but I saw an old post about scarring causing the cervix
>to not dilate fully - is this something I should be aware/concerned of?

Not really. More common top have preterm labor than scarred cervix. Possible but not common.

>4.) Large amount of abdominal scar tissue - both from c-section,
>peritonitis, exploratory abodominal surgery and surgery to remove
>adhesions from bowel.
>
>Q - How well does scar tissue hold up under labor? We are going tro
>"wait and see". Any exeperience?

Very well butthe uterine scar is not in the same category.

>Thanks,
>jennifer

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York


**Note:  Opinions expressed here are for educational purposes only
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