Difference in incision types...

kalschmi · July 2011

Hi all! I've been reading posts on the board and haven't run across this exact question yet. I read that depending on which incision I had for my c-section 10 years ago, I may or may not be a candidate for VBAC. I am going to talk more with the doctor about this in the next few appointments, but was wondering if anyone knew this to be true. I do not remember which uterine incision my previous OB used and I understand that my scar is not necessarily indicative of which way the uterine incision goes. So does anyone know if this is true, which incision, low-horizontal or vertical, would make me a better VBAC candidate? TIA! I really would like to try a vaginal delivery!

kcvasquez · July 2011

Yes, this can be true, the outside scar doesn't always resemble the inside scar. A low horizontal incision on your uterus is what makes a VBAC safer. This would be in your medical records so if you have a different OB or are going to a different hospital than where you birthed last time around, you're going to have to do some digging!

iris427 · July 2011

Low horizontal incision, aka transverse, is the safest for VBAC. A high vertical or classic incision is more likely to rupture and I believe the rupture is more likely to be catastrophic. Most doctors and midwives will not support VBAC if you have a vertical incision.

Most cesareans these days are done with a low transverse incision and I think that was true 10 years ago too. Like pp said, your medical records from the c/s should have this info.

Also, ACOG now supports VBAC with an unknown incision type. Meaning, if you can't find that information for some reason, you should still be considered a candidate for VBAC. GL!

https://www.acog.org/from_home/publications/press_releases/nr07-21-10-1.cfm

holly321 · July 2011

I know people who have tried for vbacs with the other type of incision. 1 worked, another was rcs, and the last was a uterine rupture.

I would look for your medical records, but is there no way the ob can figure out which type it is, incase they can't?

kalschmi · July 2011

Thanks for the info...hopefully my doctor or I can get the records from 10 years ago!

holly321 · July 2011

Have you gone back to the ol,d dr. since 10 years ago? practices are only required to keep records for 7 years, unless you have been there. But, we keep surgery ones until death.

bensbabe · July 2011

You have to get the report of operation from the hospital you delivered at.Your OB will request it on your behalf. In this report, the OB states the type of uterine incision. Unless you had a weirdly positioned/breech/emergency (true emergency) c/s, most likely, your incision was the "bikini cut" aka low transverse incision.....even 10 yrs ago. This is the most successful VBAC incision. HTH

kalschmi · July 2011

Hmmm, my son was breech, I wonder which incision they used. Will put a call into the OB's office for her to request those records, and I haven't been to that hospital in over 10 years now, hope my records are still there, at least archived or something. Thanks again!

holly321 · July 2011

What breech position? For frank, I would think low transverse would have been used.

kalschmi · July 2011

It was Frank...thanks.

bensbabe · July 2011

Frank would still prob be low transverse.....

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