Questioni had a vertical c-section on my 3rd baby. now i'm pregnant w/ my 4th and have to have it again. what are the risks?They Have told they will do amnio test 4weeks from due date if baby's lungs are mature will take right then. i can not find any info on this kind of situation. thank you for your time...
AnswerDear "4 baby",
Unfortunately, I can't give you an actual number or percentage as far as risk is concerned for you with a repeat classical, vertical C-Section.
I can, however, tell you I'm very encouraged that your physician is being very conscientious about the situation in planning to do an amnio at 36 weeks to determine lung development and planning an early delivery. Depending on circumstances, they may give you medications to boost lung development and will definitely be more prepared for what they are dealing with at delivery time. Being prepared makes all the difference!
As far as WHAT the risk is, and the reason they are looking into the possibility of delivering you early - anytime you have a previous scarring of that tissue, there is a bit higher risk of that tissue splitting apart at or near the previous suture line (to put it simply) as the uterine tissue stretches and grows, most especially if it begins to contract. Obviously, that would be a critical situation for both you and the baby.
The type of scar you have, a vertical scar, is on the thinner and more vulnerable part of the uterus. The risk of rupture for this type of scar has been reported to be between 4% and 9%. Having had several children and this type of scar puts you at a slightly higher risk. HOWEVER, please know that these risk numbers are based on women who attempt VBACs (Vaginal Birth After Cesarean)! So you are absolutely (in my opinion) choosing the right course in having a repeat C-Section.
I actually had to make this very same decision and I repeated because they determined that my 2nd was just too big to try a vaginal with an "untested" pelvis under VBAC conditions. A year later, I began caring for a beautiful little girl in her home. She had acquired cerebral palsy due to her mother's uterus rupturing during labor. That was a VBAC labor. Unbelievably, that mother actually has gone on to have a 3rd child via C-section who is perfectly healthy.
So... even though you are at risk for this happening, please know that it sounds like your doctors are making sure those risks are absolutely minimized. I'm sure your doctor will tell you what symptoms he would want you to call/get to the hospital for, but in the interest of being thorough, I will add a few. Vaginal bleeding, abdominal pain/tenderness or the beginning of uterine contractions, or a sharp onset of pain at the site of the previous scar would be those symptoms.
As an added note: be prepared for the amnio to be slightly uncomfortable. Not unbelievably so, but somewhat. The needle they use looks intimidating, so don't freak out. It's not the most awful thing and you will get through it, believe me - I just want you to be prepared.
I hope I've helped answer your question. I really don't like being the voice of dread in any way - but I don't think it applies here. As I said, it sounds as if your doctor has you on the best path for a positive outcome. I wish you all the best!
Brenda
