Scarred uterus

Mode of delivery

You have a scarred uterus (probably further to a previous C-Section) and you are actually pregnant.
Delivery modalities will be defined between you and your obstetrician.

C-Section will be realized under certain conditions: pathological pregnancy, breech presentation of your baby, possible big baby, and several uterine scars…)
For other situations, natural delivery can be optioned; this is called “vaginal birth after caesarean” (VBAC).
The choice between prophylactic caesarean and VBAC is based on the uterine scar, that is to say reasons of the 1st C-Section.
We can say that C-section commit to your obstetrical future, thus must be considered in full knowledge.

Complications

The main risk of VBAC is the uterine rupture (1% of risk). Uterine rupture exceptionally occurs out of the labor process. If this happen, there is unfortunately nothing to do and vital fetal prognosis is very weak.
When happening during labor, other symptoms occur (fetal heartbeat abnormalities, cervix dilation stopped, important pain in spite of anesthesia). Those symptoms will be sign for the obstetrical staff on site to perform an emergency C-Section.

Another risk must be mentioned: abnormal placentation for future pregnancies.
70% of women with a scarred uterus are geared towards VBAC, and among them 80% do have natural delivery without any problem.
Compared to VBAC, prophylactic C-Section (i.e. realized before the labor naturally begins) ou C-Section performed during the labor is liable to more severe and frequent complications (phlebitis, hemorrhage, nosocomial infections...)

Last update: 10/2/2013