Dr. said if uterus ruptures, you have to get a hysterectomy? — The Bump

Dr. said if uterus ruptures, you have to get a hysterectomy?

I am planning to have a VBAC in October after 1 CS 2 years ago due to failure to progress and an ultrasound that said my baby was 9.5 lbs when in actuality she was only 7.11.  I am nervous about the VBAC risks, but also about the RCS risks.  I hate the idea of either.  Anyway, my dr. recently told me that although my chance of UR is 1 in 100, if your uterus ruptures at all (even a little bit) you will most likely need a hysterectomy.  We are pretty sure we only want 2 kids, but this seems really final.  Has anyone else heard this or have any other advice? 

Re: Dr. said if uterus ruptures, you have to get a hysterectomy?

  • Sounds like a scare tactic. I know two personal stories where mom had uterus rupture and had kids later.
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  • Your risks are less than 1 in 100. And while a rupture CAN in severe cases lead to a hysterectomy, that is an extreme case and not common. The only person I know who has needed one was due to severe loss of blood during a c/s. (she had another underlying medical condition and they knew this was a possibility). I only know one person IRL who ruptured and it was a minor one that healed itself. She was having a RCS so it had nothing to do with VBAC anyway but the doctors didn't see it as a big issue. I grew that your doctor is just trying to sway you. There are risks to both, certainly. But that particular risk lies in both options and is very rare.
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  • I tried for a VBAC in may and ended up having a csection after about 15 hours of labor. Turned out when they opened me up, I had a uterine dehiscence. The OB said it was just a thin layer holding the baby in and she recommended I not have any more children and pushed me into a tubal by scaring the crap out of me. It wasn't my regular doctor and when I had my 6 week checkup my doctor made it sound as if I could have gone on to have more children but I would be considered a bit higher risk. He said if I were to go about trying to get pregnant again (IVF or tubal reversal), and did rupture I may need a hysterectomy and he said a hysterectomy during a csection is not really ideal. He says you're more likely to lose alot of blood because your vessels are dilated from the pregnancy. He didn't say that if you ruptured that a hysterectomy was a sure thing, but a definite possibilty.
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  • A37liciaA37licia member
    edited September 2013
    It's certainly possible but not a done deal by any means. I have read of women going on to have more children following a UR.  UR are not by default a catastrophic rupture - those stats also include dehiscence which is a separation and not an all out breaking open of the uterus. I'd encourage you do some research though and learn this valuable information personally.  This site is a good start https://vbacfacts.com/2012/04/03/confusing-fact-only-6-of-uterine-ruptures-are-catastrophic/

    And, he is overstating the risk. It's generally accepted to be 1 and 200...half of what he told you.
  • I would find another doctor, or go with a  midwife.  A lot of docs really push c/s and RCS, IMHO.  An acquaintance of mine had UR with her first (6 weeks early, even) and she is taking precautions now with her second pregnancy to avoid it.  She is also in her late 30s and obviously did not have to have a hysterectomy after her first.
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