@PetraStonegirl Question

KMW08

@PetraStonegirl‌
I'm mobile and can't remember for the life of me if your LO was born csection or vaginally?

My LO is sitting breech (I'm 35w5d) today. My OB discussed trying the external manual rotation if LO is still breech next week.

After talking about it, he got to thinking about my septum surgery and didn't know believe there are any studies/stats on possibility of uterine rupture with my history. I also have an anterior placenta.

So it's looking like if LO doesn't flip a csection will happen. Which I'm fine with whatever gets him here safely.

Guess I'm wondering if the external rotation was ever discussed with you or any knowledge you might have on it?

Or if anybody else has ever had one after a previous csection delivery?

PinkCamino

I know I wasn't paged to this but wanted to tell you what my doc said.

The surgeon who resected by septum told me that there is a possibility of uterine rupture and that he'd advise a C-section without doubt.

KMW08

PinkCamino said:

I know I wasn't paged to this but wanted to tell you what my doc said.

The surgeon who resected by septum told me that there is a possibility of uterine rupture and that he'd advise a C-section without doubt.

Thanks for chiming in @PinkCamino‌ :-*! I almost paged you to this thread because I knew your surgeon was pretty thorough with you. My doc probably told me, but I can't for the life of me remember

chicagojackie

@KMW08 I don't think you're a candidate for ECV unless they are ready to crash you and baby if anything goes wrong. If they were going to do it you should do it in an OR with your OB and the neonatologist (or at least a pediatrician/hospitalist) in the hospital.

One of the absolute contradindications to ECV is "uterine anomaly." The best study I could find on the topic featured low-risk women and in that group 6% had a complication. 6% is an awful lot. I don't have a surgical cuterus and I don't know that I would agree to the procedure. Sometimes when babies are breech there is a reason and if it has to do with the placenta or cord you don't want to go there. Sometimes not. Why gamble is my philosophy. Healthy baby, healthy momma, move on.  

KMW08

PetraStonegirl said:

Hey there, I can't believe you are so close! Pebbles presented breech or transverse pretty much the entire time. However, since vaginal wasn't even a remote possibility, a version was never discussed.

I kind of feel like any time a ute has been cut through structurally, it increases the chances of a rupture. I had several penetrative surgeries. However, septum surgeries do no always penetrate the musculature of the ute. So, it leaves some debate about the risk for a given patient.

I would honestly have your OB speak with your surgeon, but regardless, if your OB feels that it is safer to move ahead with a scheduled c-section I'd lean towards listening.

Best of luck!

Thanks @PetraStonegirl‌. I'm fairly certain most corrected ute surgeries are about the same risk as a vbac. My OB did say he would like to skip induction meds if at all possible due to my history. Obviously if a csection is my safest route I will go that way.

KMW08

chicagojackie said:

@KMW08 I don't think you're a candidate for ECV unless they are ready to crash you and baby if anything goes wrong. If they were going to do it you should do it in an OR with your OB and the neonatologist (or at least a pediatrician/hospitalist) in the hospital.

One of the absolute contradindications to ECV is "uterine anomaly." The best study I could find on the topic featured low-risk women and in that group 6% had a complication. 6% is an awful lot. I don't have a surgical cuterus and I don't know that I would agree to the procedure. Sometimes when babies are breech there is a reason and if it has to do with the placenta or cord you don't want to go there. Sometimes not. Why gamble is my philosophy. Healthy baby, healthy momma, move on.  

@chicagojackie‌ ecv would def be done on L&D with OR ready if needed. My OB said we'd discuss it further at my appt next week, and if ecv is decided it would be scheduled for the following week, putting me closer to 38wks.

I'm really hoping lil guy flips on his own. Anything is possible. I've def been thinking about cord and placenta issues. My mom lost a baby due to a cord incident and it almost happened with me too. My aunt said my mom also had placenta previa with both of her pregnancies.

I'm thinking next week I'll probably have a more definitive plan set & possibly a csection date. CRAZY!

ToriGirl2014

Holy crap ladies ... my OB and RE (surgeon) never mentioned uterine rupture as a risk following my uterine/cervical/vaginal septum resections.

Glad I saw this -- will be bringing it up at my next OB appointment for sure.

Assumed I could still go with a vaginal delivery.

KMW08

ToriGirl2014 said:

Holy crap ladies ... my OB and RE (surgeon) never mentioned uterine rupture as a risk following my uterine/cervical/vaginal septum resections.

Glad I saw this -- will be bringing it up at my next OB appointment for sure.

Assumed I could still go with a vaginal delivery.

@ToriGirl2014 my OB and RE were both fine with vaginal delivery for me. I'm just at a crossroad right now since my lil guy is breech.

But to clarify, as Petra mentioned, there is a slightly increased risk of uterine rupture anytime the uterus has anything surgically done (this includes csections & why there's so much hype about vbac). My OB was the first to ever mention his concern about induction meds with my ute though. I didn't really ask but I assumed he has the same concerns with induction with vbac ladies. Something about the meds causing stronger contractions & could lead to an increased chance of rupture since technically the uterus is already weakened due to having septum surgery.

RedCherry1109

My doctor is taking my 2 weeks early since I've had 3 c-sections. She put me as high risk since there is a chance of uterine rupture.

Junebug060609

@KMW08 I'm so excited you're so close! No experience with resections or versions, but I'm with the others in that I'd not risk it. FWIW, I had an anterior placenta and ended up with an unplanned c/s with DD (pushed for an hour with no progress and decels on her). C/S aren't a walk in the park, but I thought it would be much worse than it was. Andplusalso, both of my kids flipped right around where you're at (maybe a smidge earlier). Hopefully yours does as well!

ToriGirl2014

@kmw08 - still very glad for the information. I've still got time for LO to flip but she's been lying transverse basically the entire pregnancy. Hope your LO moves into position.

chicagojackie

@KMW08 I think in your case another potential consideration regarding C-section would be you and H's wishes for more children. If you and your physicians are thinking this is a one and done scenario, it may be most safe to go ahead and have the C-section. If you are thinking you want to have another one, it might be best to try for the vaginal delivery and avoid another incision on the (c)uterus. Just another point to think of with the surgeons...future childbearing (or not).

Lots of hugs to you. Healthy mama, healthy baby is what you need, no matter the route.

BootsOrHearts

Dirty lurker here. . .. . I had a fibroids removed like @petrastonegirl and was told under no uncertain terms that I could not deliver vaginally and in fact, I wasn't even allowed to go into labor on my own because of the risk of uterine rupture so they wanted to take baby between 36 and 37 weeks. Granted my surgeries were pretty invasive but I still feel they were a bit overcautious because another lady in my c-section class  had fibroids removed too and they were at least letting her get to 39 weeks. Anyway it was all a moot point because baby was breech and I had pre-e so he ended up coming at 36 weeks. 

My point is there is a huge difference between doctors and what level of risk they are comfortable with but one this is for certain and that is no doctor will allow you to be induced after a VBAC or any uterine surgery, that ups the risk of rupture in a big way compared to natural labor. Nor would say, home birth be a good idea for someone in that category!

Hopefully you come up with something that makes sense for you. Vaginal birth is nice (did I really say that?) but at the end of the day, whatever gets baby here safely is just fine so dont' stress either way. 

Drgn30

I'm so glad I saw this post.  I haven't even been thinking about how my resection could impact labor and delivery.  Definitely bringing it up with my OB next week.

chicagojackie

BootsOrHearts said:

Dirty lurker here. . .. . I had a fibroids removed like @petrastonegirl and was told under no uncertain terms that I could not deliver vaginally and in fact, I wasn't even allowed to go into labor on my own because of the risk of uterine rupture so they wanted to take baby between 36 and 37 weeks. Granted my surgeries were pretty invasive but I still feel they were a bit overcautious because another lady in my c-section class  had fibroids removed too and they were at least letting her get to 39 weeks. Anyway it was all a moot point because baby was breech and I had pre-e so he ended up coming at 36 weeks. 

My point is there is a huge difference between doctors and what level of risk they are comfortable with but one this is for certain and that is no doctor will allow you to be induced after a VBAC or any uterine surgery, that ups the risk of rupture in a big way compared to natural labor. Nor would say, home birth be a good idea for someone in that category!

Hopefully you come up with something that makes sense for you. Vaginal birth is nice (did I really say that?) but at the end of the day, whatever gets baby here safely is just fine so dont' stress either way. 

Um. DID YOU REALLY SAY THAT? Haha. Delivering my 7# daughter in an occiput posterior (face up) position was the HARDEST thing I have ever done in my life and I'm not sure I'd characterize it as "nice." I would use terms like "terrifying", "thought I was going to die", "had to get through it" and "what do you mean, deliver the shoulders?!?"

KMW08

Drgn30 said:

I'm so glad I saw this post.  I haven't even been thinking about how my resection could impact labor and delivery.  Definitely bringing it up with my OB next week.

I almost paged you to see if you had any info on this too. I'm glad this discussion is helping others too!

KMW08

BootsOrHearts said:

Dirty lurker here. . .. . I had a fibroids removed like @petrastonegirl and was told under no uncertain terms that I could not deliver vaginally and in fact, I wasn't even allowed to go into labor on my own because of the risk of uterine rupture so they wanted to take baby between 36 and 37 weeks. Granted my surgeries were pretty invasive but I still feel they were a bit overcautious because another lady in my c-section class  had fibroids removed too and they were at least letting her get to 39 weeks. Anyway it was all a moot point because baby was breech and I had pre-e so he ended up coming at 36 weeks. 

My point is there is a huge difference between doctors and what level of risk they are comfortable with but one this is for certain and that is no doctor will allow you to be induced after a VBAC or any uterine surgery, that ups the risk of rupture in a big way compared to natural labor. Nor would say, home birth be a good idea for someone in that category!

Hopefully you come up with something that makes sense for you. Vaginal birth is nice (did I really say that?) but at the end of the day, whatever gets baby here safely is just fine so dont' stress either way. 

I'm glad you can confirm the bolded for me @BootsOrHearts‌ It does amaze me at the extreme differences in OBs comfort levels, but I'm all about trusting my OB and doing whatever he is most comfortable with to get LO here safely since this is his area of expertise. I just like being informed and having some knowledge to help me process and try to battle the mental aspect of labor.

chicagojackie

PetraStonegirl  absolutely her future fertility is a back-burner consideration however it is something that should be discussed since her and her doctor's decision this time could affect/limit her decision making later on. Obviously the safest route must be taken but she should be prepared for all of the implications of that choice.

KMW08

chicagojackie said:

PetraStonegirl  absolutely her future fertility is a back-burner consideration however it is something that should be discussed since her and her doctor's decision this time could affect/limit her decision making later on. Obviously the safest route must be taken but she should be prepared for all of the implications of that choice.

I think the real concern is the version. From what I find, I interpret it as version is contraindicated for known uterine anomalies that can't be or haven't been corrected. There's not much out there about trying version with a surgically corrected anomaly. So everything speculated is being based and treated off of as if I had a prior csection.

I've never had a lap, so essentially I don't have any cut into the muscle, but there's always concern of uterine integrity and strength after you've had any type of uterine procedure, including a csection. So rupture is the greatest concern right now, which is why my OB isn't too sure about trying a version.