PREGNANCY-BIRTH Messages for August, 1999: Re: Uterine scar

Re: Uterine scar

From: William D. McIntosh, MD (anonymous@obgyn.net)
Mon, 30 Aug 1999 14:16:54 -0500 (CDT)

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At Mon, 30 Aug 1999, anonymous@obgyn.net wrote: >
>In a message dated 8/28/99 1:54:20 PM, kat52gre@excite.com writes:
>
><< Was there are problem with a big baby? As a nurse the only time I have
>seen them make a T incision, was when they had difficulty with delivery of
>infants head through the Kerr (low transverse) uterine incision; Or if the
>infant was in a malposition or if it was an emergency for fetal distress. A
>Kerr incision is usually, but not always adequate. I am sure there are other
>reasons also, but I can't come up with them at this time.
> This inverted T uterine incision also probably has a name but I'm not
>gonna get that one to come to me right now. This should pose no problems
>with the pregnancy, but I'm not sure if you would qualify for a VBAC with
>this type of uterine incision. I would discuss this with your physician
>ahead of time.
> Hope this has been some help. Kathy
> >>
>I did not see the original message on Uterine Scars but am interested in this
>topic. I had a T incision 5 years ago when I delivered my son and was told
>that I should never consider a VBAC because of possibility of rupturing. I
>am due to have a 2nd C-Section on 9/24 and am curious if the doctors agree
>that a C-Section is my only choice. Also, if I do go into labor should I
>head straight to the emergency room because the area is so vulnerable to
>rupture or am I not in that much danger. (I recently moved and live one and
>a half hours from the hospital that I am scheduled to deliver in - didn't
>want to change doctors this late.
>Amanda
>amandawbr@aol.com

An inverted "T" incision is inherently very weak, and the chances of rupture are around 15% or higher. You are not a candidate for a VBAC, even for me, and I am more aggressive than most (for example, I will consider a trial of labor for an unknown scar in the selected patient). You should go to the hospital immediately when firm, painful contractions begin, and you should make arrangements to be much closer to your hospital as you get closer to term.

-- William D. McIntosh, MD, FACOG Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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