If so - what type of incision did you have (i.e. transverse or vertical)? I had a c-section with DS due to complete placenta previa and according to my surgical report my scar is low in the uterine segment and transverse. However, I keep reading in different books and publications that they typically have to make a vertical incision with placenta previa. I want to believe my report but I'm just wondering why I keep reading this...
One reason I'm really interested is because I am going for a VBAC this time and the risk of scar separation is much lower with a transverse incision (which I'm really hoping is what I have). Unfortunately the Dr. who did my c-section was the "on-call" OB at a different hospital who I have no contact with, so I just have my report to go off of. I would think it's extremely rare for the report to be incorrect, but I'm getting really anxious now after I keep reading c-sections for placenta previa are always vertical
So, if anyone out there has BTDT or has any info, it would be much appreciated. Thanks
Evie - brand new! 3/25/10
I haven't had a c/s due to placenta previa, but I have had 4 c/s's (and a 5th coming this July).
A transverse incision is one that is made side to side and vertical is done up and down. If your incisional scar is side to side, then you did, in fact, have a c/s with a transverse incision. If you had had a vertical incision, you'd be extremely hard pressed to find someone willing to participate in a VBAC since there's a lot more tissue (muscles, etc.) cut with a vertical incision which increases the risk for ruptures.
I think the reason vertical incisions are more common in situations with placenta previa is because the placenta is probably also a little anterior and there's concern of cutting into the placenta with a low, transverse incision.
I hope that helps!
Katelyn (14), Michael (12), Issac (4), Rebecca (2), Evan (ARR 7/27)
I know that my mom had an emergency c-section at 28 weeks from placenta previa and went on to have a VBAC (granted, 10 years later), but I'm sure her incision was not vertical/classical because we live in one of the most vbac-unfriendly states (midwives aren't even legal) and so they definitely wouldn't have let her vbac if that had been the case.
I did have a classical c-section (not due to placenta previa but due to being so early) and believe me, they pounded it into my head during my hospital stay (they= my doctor, nurses, random other doctors who checked on me, etc.) that this means I can never go into labor and that I need to make sure I tell all of my future doctors that I had a classical c-section. I would like to think that they would have told you that at least you'd had a classic if that's what happened, but I guess you shouldn't assume.
Me-26 DH-29 --my blog-www.butterflies-and-rainbows.blogspot.com
DD-Olivia, angel baby, 9-28-09, 23+2 wks class I HELLP/severe pre-eclampsia, emergency classic c-section (1.5 years ttc)
DS- April 2011, 36w2d, 7lbs 4 oz, 20 inches. (Stressful high risk pregnancy, lovenox and low dose aspirin and gd, but pre-eclampsia and HELLP-free and perfectly healthy baby boy.) (femara 7.5 mg, HSG-all clear, trigger cd 14, IUI 38 hours later, circle + bloom= BFP 11 dpo (9 cycles TTC))
"If your incisional scar is side to side, then you did, in fact, have a c/s with a transverse incision. "
Just to clarify, the external scar is still side to side either way. I did have a vertical c-section but the scar that I can see is horizontal. It's the scar that's internal on my uterus that's vertical.
I have read somewhere about someone getting an ultrasound and seeing the scar on that. Maybe I misunderstood what they posted but you could at least ask about it.
I would suggest having an u/s to check the scar placement. I know both my scars show up on the ultrasounds I have had. I would tend to believe the u/s report though. Good luck on your VBAC!
That's weird. I asked during my second ultrasound if she could see the scar(s) from my previous C-sections, and she said she couldn't. I can't remember why not though. Maybe b/c it has been 9+ years since my last one? Can they only see them via internal u/s?
Tami ~ 41 Steve ~ 42 Est. 3/19/94 Ryker ~ 14.2 (C/S) Hudson ~ 11 (VBAC!) Cameron ~ 9.5 (C/S) & Shepard ~ 5/6/10 (C/S)
My section is low-traverse as well. I read the entire report that my doctor wrote and no where is the word vertical mentioned.
I would trust the post-operative report. Have you given it to your new OB and what is his/her opinion?
Thanks everyone, your comments have been really helpful
AngieB, thanks for clarifying that point about the scar on your skin versus the one on your uterus. The one on my skin is low and transverse, but I know that the uterine scar could be different, and that's the one that matters!
I will ask about the possibility of seeing it on an u/s. I never knew it could even be visualized on there. My OB has seen the surgical report (we talked about it very early on) and is not concerned. I haven't even mentioned this new concern to her. I just started worrying about it this past week when I kept reading that placenta previa c-sections are done vertically. I will talk to her about it during our visit next week and get her thoughts.
FWIW, I do think it's highly unlikely that the report is incorrect. I'm just getting anxious about the "what ifs" as I near my due date and the reading I've been doing lately isn't helping. As AngieB mentioned, I would think due to the implications of a classical/vertical incision, they would have likely made a big deal about it if that's what happened. I really want to trust the report. I will probably feel better after speaking with my Dr., and if there is a chance she could see the scar on an u/s that would be all the better. I just want these fears behind me so I can focus on the birth
My friend had an emergency c/s due to a placenta previa that hemorrhaged at 34 weeks. It was done transverse and her doctor specifically told her she should be able to try a VBAC the next time as long as there is no placenta previa again.
This isn't true at all--the incision on the outside is NOT necessarily the same as the incision on the inside. You can have a low transverse excision of your skin, but a vertical incision on your uterus. Most of the time, docs will at least try to give you a low transverse on the outside, b/c the scar can be hidden. Sometimes, it's not possible to do this incision as low transverse b/c of time or previous scarring.
It's the scar on the *uterus* that docs care about--the one on the outside doesn't matter at all to them.