QuestionThank you for your quick response! I gather from the info you provided that a uterine window is a permanent conditon which cannot be improved. Considering this, what is my risk for spontaneous rupture? I do have a c-section scheduled May 15 (week 38) but my belly is very large and I worry about rupturing spontaneously at any moment. Is this possible? If so, what can I can do to detect or prevent it? Thanks, Cathy
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Followup To
Question -
Hello Dr Rappaport;
I was told I had a large, anterior uterine window on the lower segment of my uterus surrounding a previous c-section scar visible at my last c-section (which was my 2nd). The baby was 2 weeks overdue and nearly 11 lbs. I am now pg with #4 and wondering if there is anything I can do to prevent this from happening again? It has been suggested I should wear a belly support, take herbs (red raspberry, blue/black cohosh)to tone the uterus, and reduce carb & sugar intake to minimize baby size. Are these really helpful? Also, please tell me: Does a uterine window repair itself between pregnancies (like any other muscle) or is it a permanent condition? Thanks, Cathy
Answer -
A window that is seen at the sight of a previous cesarean section scar usually is due to a weakness in the previous incision, causing a thinning of the surrounding tissue. This will probably cause more problems at the time of the next delivery and it is adviseable that you do not allow yourself to go into labor. A repeat cesarean section should be performed no later than 38 weeks gestation in order to avoid going into labor and having further weakness of the scar and the risk of uterine rupture.
AnswerSince there is a 1% risk of uterine rupture at the site of the previous incision, the key to to have the cesarean section performed prior to going into labor. As long as you are scheduled to have the operation before 38 weeks gestation, you should not have any problems.
