Question-------------------------
hi, just thanking again for your help, also wondering what the dangers would hold in case i was one of the 1% at risk of uterine rupture if i am to go into labour early, and how late does the risk set in if i am to go into labour say weeks or months b4 the ceasar is due, is there such a thing as the baby being small enough to exit without any warning as i was told with my second after i discovered my water leaked without detection from doctors or midwives and would this pose a risk . i have many questions and worries haunting my dreams, mostly due to the ordeal experienced with my 3 mth prem,and the information i recieved during and after my troubled pregnancy although completely different situations im jsut dreading going through it all again, and then there is this fear i have of being hospitalised early again, as i have developed some kind of a phobia of staying at hospital, hosp visits dont bother me, but the thought of having to stay in one for more than a few days is very daunting, even petrifying for me to consider, so i try to avoid the thoughts so that i may be able to stay half calm and relaxed as possible with 2 young kids to love and care for.thanx for your time and i appreciate what you are doing for all these people out here in need of reassurance/advice/information and all else you do for all who ask for ur assisstance
Followup To
Question -
hi there,at 23 i am nearly 18 wks along with my 3rd child, 1st preg not a problem, healthy girl now 5 delivered naturally with only slight grazing, second child was born at 26 weeks due to prem rupture of membranes around 20 wks and delivered at 26 wks, now 16 mths old via emergancy classical ceasar after my placenta pulled away from wall, i was told that i should not have another baby for at least two years, yet time saw things differntly aand 1 year later i fell pregnant with my 3rd child(lmp approx 25/8/03), i am aware that i have to undergo another c-section, but have had mixed reports about what to expect, i am terrified of tearing before or during the lead up to labour, if i am at risk i still dont know, doctors say im fine, young and healthy and nothing to worry about, yet when out of fear i went to the abortion clinic and was told that i was at great risk, yet when i went through to have it done, they waited till i was in the chair and preparing for op when they refused to go ahead as they felt that i was not fully 100% wanting the op, i will admit although i was nervous, i was quite sure it was right, as there is so much fear of what to expect, and for my own health and my families sake i felt i was doing the right thing, with mixed feelings of dread,guilt etc,and decided to go ahead with it based on the doctors views rather than the clinic dr, i am now quite dreading what this pregnancy holds in store for me, yet we are excited to be adding another child to our family, we cannot get past the fear that i was told to wait 2 yrs, and in half that time, we are expecting again, are we silly for having hope that this may be a positive situation with a positive outcome?
Answer -
Do not worry at all. The recommendation of ACOG (American College of ObGyn) is that if you had a cesarean section, you should not attempt a VBAC (vaginal birth after cesarean) until 18 months have passed. The scar from your previous cesarean is already healed. There is, however, a 1% risk of uterine rupture at the site of the previous uterine scar if you go into labor. There is no risk in carrying the pregnancy, nor any risk prior to going into labor. Due to the fact that you hade a classical cesarean section (vertical incision in the uterus), it is recommended that you undergo a repeat cesarean section PRIOR to going into labor, in order to avoid any risk of rupture. We usually suggest that the surgery is scheduled for around 38 weeks gestation (based on sonographic measurements at 20 weeks). In any event, please do not worry. Many, many women have repeat cesarean sections for the exact same reason as you and the risk is very minimal. Good Luck with the pregnancy.
AnswerThe risk of uterine rupture is the same whether you go into labor at term or if you go into labor early. In your situation, it is important to constantly be aware if you are having any contractions or if you are leaking any fluid. Drink plenty of water. Drink like its going out of style. If you are well hydrated, you will not go into preterm labor. If you have any signs of regular contractions, call your doctor. YOu may be able to start Brethine (terbutaline) to prophylactically prevent contractions. Discuss it with your doctor. As long as you are not in booming labor, you do not have to worry about rupture of your uterus. However, once you are in labor, make sure that you are on a fetal monitor, and, if there are any signs of trouble, a repeat cesarean should be done.
