Second time mom the first being a c-section

MechanicMama1

Have you ever herd of the baby implanting on the c section scar? Also did the fear of uterus rupturing turn you to schedule a second c section?

honkytonk_kid

I have heard of the placenta implanting on the scar, and other placenta/scar related issues. From the NIH VBAC statement:

The incidence of placenta previa (placenta covering the cervix) significantly increases in women with each additional cesarean delivery, occurring in 900 per 100,000 women who have one prior cesarean delivery, 1,700 per 100,000 women who have two prior cesarean deliveries, and 3,000 per 100,000 in women who have three or more cesarean deliveries. As the number of cesarean deliveries increase, major morbidity, including placenta accreta and hysterectomy, also increase when a pleacenta previa is present.

Even in the absence of placenta previa, the incidence of placenta accreta, increta, and percreta (growth of the placenta into or through the uterine muscle) increases with the number of cesarean deliveries. This has a profound effect on the woman?s future reproductive capability. The baseline risk of placenta accreta in a woman with one prior cesarean delivery is 319 per 100,000; this increases to 570 per 100,000 for two prior cesarean deliveries, and approximately 2,400 per 100,000 for three or more cesarean deliveries. No factors have been identified to decrease this risk. There does not appear to be an increased incidence of placental abruption (i.e., premature separation of the normally implanted placenta from the uterus) with increasing number of cesarean deliveries, although the risk is increased when women who have one prior cesarean delivery are compared to women who have not had a cesarean delivery.

No, the fear of a rupture would not lead me to schedule a RCS. The risk of a catastrophic rupture (that it, a rupture that leads to perinatal death) is around 6% of the less that 1% of VBACs who rupture.

IMO, VBAC and RCS are both reasonable and reasonably safe choices- the best choice for you depends on your unique situation- but the choice either way should not be motivated by fear due to incorrect information.

MechanicMama1

Thank you for this information... I guess I am thinking that since my scar is soo fresh it would be easier to rupture.